Introduction

An ehealth-message defines written communication and comes in four flavours depending on the “category” of the message:

• Message: For sending user-generated messages from Patients and CareTeams (Practitioners) to Patients or CareTeams. Messages may not be sent between Patients or between Practitioners. When sending a message to a CareTeam, it is possible to narrow the recipient to be of a certain role. This is done by setting the “restriction-category” extension to a specific role value.
• Notification: Must regard an incident or event that has already occurred, where the sender must be of type Device, and the recipient must be a Patient or CareTeam. These are usually text-based, and may have a temporal validity attached (see “period” extension) to indicate at which point a notification is no longer valid. When sent, a notification may no longer be updated by the sender.
• Advise: Advise is much like notifications. They may also have a validity period, but they may only concern a future planned event, eg. a measurement or online meeting which is to take place. The sender must be of type Device, and the recipient must be a Patient or CareTeam
• Note: For personal notes (written by a Patient or Practitioner), which may be shared with a CareTeam. A personal note must be created with sender=recipient. In case a personal note wants to be shared with a CareTeam, the CareTeam must be referred by the recipientCareTeam extension, and the receiver deleted (both can take place in the same PATCH operation). A personal note may be updated by the sender, but not by the recipient.

An ehealth-message may refer related resources (eg. Device, CarePlan, Appointment etc) using the “about” field, no matter which category it is. Different instances of ehealth-message may be logically organized into “threads” by assigning the same thread-id in the provided extension. Similarly, they may be organized in a group (eg. group messages) by assigning the same group-id in that extension. The message subject may be provided in the title extension, and an optional priority may be provided in the ehealth-priority extension.

Remarks about status and administrative-status

The ehealth-message profile contains two status fields:

• status:
  • For notes (category=’note’) the status field has no restrictions or implications
  • For messages (category=’message’) the following status transitions rules are in effect:
    • A message is considered “not yet sent” when it has one of the following status and can freely transition from one to another: ‘preparation’, ‘on-hold’, ‘not-done’, ‘entered-in-error’
    • A message is considered “being sent” when created or patched into status ‘in-progress’ and cannot be patched further or deleted by the sender
      • The server will automatically transition a message from ‘in-progress’ to ‘completed’ when it has been sent successfully (happens immediately for non-NemSMS mediums and is reflected in the returned resource)
      • The server will automatically transition a message from ‘in-progress’ to ‘stopped’ if it could not be sent (currently only happens if a NemSMS could not be sent)
    • The client can never create or patch a message into status ‘completed’ or ‘stopped’
    • The sender cannot patch, only delete messages with status ‘stopped’
    • The sender cannot patch or delete messages with status ‘completed’
    • The recipient can patch /received and administrative-status on messages with status ‘completed’
• administrative-status (extension): Makes it possible for the message recipient to indicate the state of a message. A message may hold an administrative status that defines the last action the recipient took on the message in question. At first, the message has administrative-status “activate”. The recipient may mark the message as read by setting administrative-status “read”. If the recipient considers the message a sort of “task”, the message may also be updated with administrative-status “complete” when the task is done, or “reactivate” if the task was not complete anyway.

Fields with auto-assigned values

Some fields are filled in automatically on message creation, eg. if a sound default value makes sense. These fields are:

• Field “sent”: If message state is set to “in-progress” on creation, then the “sent” field will be assigned current date/time.
• Extension “restriction-category”: If not set by the caller, it will be set to value “None”
• Extension “thread-id”: In case a thread-id is not set by the client, it will be generated server-side (random UUID) at message creation.

Search parameters

The following custom search parameters may be used when searching for ehealth-message instances:

• administrativeStatus: Specify the desired administrative status using system and code (eg. “http://ehealth.sundhed.dk/cs/administrative-status” and “read”)
• careTeamRecipient: Specify an absolute reference to the CareTeam which must be message recipient
• careTeamSender: Specify an absolute reference to the CareTeam which must be message sender
• communicationCategory: Specify the desired category using system and code (eg. “http://ehealth.sundhed.dk/message-category/” and “message”)
• period: Use a date-type search to filter messages that must conform to temporal constraints (eg. notifications that are only valid until a specific point in time)
• threadId: Specify the logical “thread id” used to correlate messages
• restrictionCategory: Specify the desired restriction category using system and code (eg. “http://ehealth.sundhed.dk/cs/restriction-category” and “measurement-monitoring”)
• episodeOfCare: Specify the desired episodeOfCare reference (provided in extension http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare)

Scope and Usage

In the eHealth Infrastructure the ehealth-message resource is used in conjunction with the following resources:

• Patient
  • As sender or recipient of a message
• Practitioner
  • As sender/recipient of a message (only when category is “note”)
• Device
  • As sender of an ehealth-message (eg. as a result of automatic processing/triage)
• CareTeam
  • As sender or recipient using the extensions senderCareTeam/recipientCareTeam, respectively

General rules

The following rules apply for the ehealth-message profile:

• If medium.code is eboks or nemsms, the recipient must be of type Patient
• Only one of sender or extension senderCareTeam may be filled in
• Only one of recipient or extension recipientCareTeam may be filled in
• Medium ‘nemsms’ may only be used if the Patient allows reception of NemSMS (has telecom with value ‘NemSMS’). In that case, a NemSMS message will be sent to the Patient.

NemSMS Notifications

The Patient service will forward ehealth-messages to the public Danish NemSMS service given the following conditions:

• message.medium.code is ‘nemsms’ (defined in http://ehealth.sundhed.dk/cs/message-medium)
• message.status is ‘in-progress’

The message is forwarded asynchronously. To track the progress of the NemSMS, the status and statusReason code is used:

• Initially, a NemSMS is sent like any other message by setting the status to ‘in-progress’. The status will remain ‘in-progress’ while the NemSMS is being dispatched.
• If the NemSMS dispatch is successful, status is updated to ‘completed’ by the server.
• If the NemSMS dispatch fails, status is updated to ‘stopped’ by the server and statusReason is set to either ‘system-error’ or ‘recipient-unavailable’ (defined in http://hl7.org/fhir/R4/valueset-communication-not-done-reason.html)
  • A message.note.text may be added to the message which can contain further information about the reason for dispatch failure in case of ‘system-error’

Automatic NemSMS Notifications

Automatic NemSMS notifications is a toggleable feature at the service level. If enabled, the Patient service will generate NemSMS ehealth-messages, notifying the recipient that they have received a message, given the following conditions:

• message.medium.code is not ‘nemsms’
• message.status is ‘completed’
• message.category is ‘message’ (defined in http://ehealth.sundhed.dk/cs/message-category)
• message.recipient is a Patient reference
• patient.telecom contains ContactPoint ‘NemSMS’

The Patient service will generate NemSMS ehealth-messages, notifying patients that they have an appointment or video appointment scheduled for de following day, given the following conditions:

• appointment.start is current day + 1 day
• appointment.participant contains one Patient reference
• patient.telecom contains ContactPoint ‘NemSMS’

Update rules

An ehealth-message may not have its category changed, eg. from ‘note’ to ‘message’.
An ehealth-message may be PATCH updated on paths complying with the regular expressions below (provided that security and status transition rules are obeyed)

• /implicitRules.*
• /contained.*
• /recipient.*
• /definition.*
• /basedOn.*
• /partOf.*
• /topic.*
• /about.*
• /context.*
• /received.*
• /reasonCode.*
• /reasonReference.*
• /payload.*
• /note.*
• /status.*
• /extension.*

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Communication

Name	Flags	Card.	Type	Description & Constraints
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver nemsms-invariant: If communication resource is a NemSMS payload cannot exceed 160 note-invariant: Category note invariant notification-invariant: Category notification invariant message-invariant: Category message invariant advice-invariant: Category advice invariant
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
episodeOfCare		0..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
recipientCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam
senderCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message sender URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam
restrictionCategory		0..*	CodeableConcept	Restriction category URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-restriction-category Binding: Restriction Category (required)
threadId		0..1	string	Thread id URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-thread-id
period		0..*	Period	Specifies the temporal validity of an ehealth/message instance URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-period
administrativeStatus		1..1	Coding	The administrative status of how a message recipient has handled a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-administrative-status Binding: Administrative Status (required)
title		0..1	string	Message title URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-title
priority		0..1	code	The priority of a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-priority Binding: Priority (required)
groupId		0..1	string	Logical id identifying a set of messages with the same recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-group-id
onBehalfOf	S	0..1	Reference(ehealth-careteam) {r}	On behalf of URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-on-behalf-of
partOf		0..*	Reference(CarePlan) {r}	Part of this action
Slices for category		1..*	CodeableConcept	Message category Slice: Unordered, Open by value:coding.system
category:DkTmCategory		1..1	CodeableConcept	Message category
coding
system		1..1	uri	Identity of the terminology system Required Pattern: http://ehealth.sundhed.dk/cs/message-category
code		0..1	code	Symbol in syntax defined by the system Binding: MessageCategory (required)
Slices for medium		0..*	CodeableConcept	A channel of communication Slice: Unordered, Open by value:coding.system
medium:DkTmMedium		0..1	CodeableConcept	A channel of communication
coding
system		1..1	uri	Identity of the terminology system Required Pattern: http://ehealth.sundhed.dk/cs/message-medium
code		0..1	code	Symbol in syntax defined by the system Binding: MessageMedium (required)
recipient		0..1	Reference(Patient | Practitioner) {r}	Message recipient
sender		0..1	Reference(Device | Patient | Practitioner) {r, c}	Message sender
reasonCode		0..*	CodeableConcept	Indication for message Binding: eHealth Message Reason Code (required)
reasonReference		0..*	Reference(Condition | Observation) {r}	Why was communication done?
payload		0..1	BackboneElement	Message payload
Slices for content[x]		1..1	string	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentString		1..1	string	Message part content
note
Slices for author[x]		0..1	Reference(Practitioner | Patient | RelatedPerson | Organization), string	Individual responsible for the annotation Slice: Unordered, Open by type:$this
author[x]:authorReference		0..1	Reference(ehealth-practitioner | ehealth-patient | ehealth-relatedperson)	Individual responsible for the annotation
author[x]:authorString		0..1	string	Individual responsible for the annotation
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Communication.category:DkTmCategory.coding.code	required	MessageCategory http://ehealth.sundhed.dk/vs/message-category from this IG
Communication.medium:DkTmMedium.coding.code	required	MessageMedium http://ehealth.sundhed.dk/vs/message-medium from this IG
Communication.reasonCode	required	eHealth Message Reason Code http://ehealth.sundhed.dk/vs/message-reasonCode from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
advice-invariant	error	Communication	Category advice invariant : category.coding.code = 'advice' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())
message-invariant	error	Communication	Category message invariant : category.coding.code = 'message' implies (recipient.reference.contains('Patient/') and ( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists())) or (( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and (sender.reference.contains('Patient/')) or (extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists() ))
nemsms-invariant	error	Communication	If communication resource is a NemSMS payload cannot exceed 160 : medium.coding.where(code = 'nemsms').exists() implies payload.contentString.length() <= 160
note-invariant	error	Communication	Category note invariant : category.coding.code = 'note' implies (sender.reference = recipient.reference) or (recipient.reference.exists().not() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists())
notification-invariant	error	Communication	Category notification invariant : category.coding.code = 'notification' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())

Name	Flags	Card.	Type	Description & Constraints
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver nemsms-invariant: If communication resource is a NemSMS payload cannot exceed 160 note-invariant: Category note invariant notification-invariant: Category notification invariant message-invariant: Category message invariant advice-invariant: Category advice invariant
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
episodeOfCare		0..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
recipientCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam
senderCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message sender URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam
restrictionCategory		0..*	CodeableConcept	Restriction category URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-restriction-category Binding: Restriction Category (required)
threadId		0..1	string	Thread id URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-thread-id
period		0..*	Period	Specifies the temporal validity of an ehealth/message instance URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-period
administrativeStatus		1..1	Coding	The administrative status of how a message recipient has handled a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-administrative-status Binding: Administrative Status (required)
title		0..1	string	Message title URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-title
priority		0..1	code	The priority of a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-priority Binding: Priority (required)
groupId		0..1	string	Logical id identifying a set of messages with the same recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-group-id
onBehalfOf	S	0..1	Reference(ehealth-careteam) {r}	On behalf of URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-on-behalf-of
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
partOf	Σ	0..*	Reference(CarePlan) {r}	Part of this action
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): The status of the communication.
Slices for category		1..*	CodeableConcept	Message category Slice: Unordered, Open by value:coding.system Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
category:DkTmCategory		1..1	CodeableConcept	Message category Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
Slices for medium		0..*	CodeableConcept	A channel of communication Slice: Unordered, Open by value:coding.system Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
medium:DkTmMedium		0..1	CodeableConcept	A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
recipient		0..1	Reference(Patient | Practitioner) {r}	Message recipient
sender		0..1	Reference(Device | Patient | Practitioner) {r, c}	Message sender
reasonCode	Σ	0..*	CodeableConcept	Indication for message Binding: eHealth Message Reason Code (required)
reasonReference	Σ	0..*	Reference(Condition | Observation) {r}	Why was communication done?
payload		0..1	BackboneElement	Message payload
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for content[x]		1..1	string	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentString		1..1	string	Message part content
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Communication.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 from the FHIR Standard
Communication.category	example	CommunicationCategory http://hl7.org/fhir/ValueSet/communication-category from the FHIR Standard
Communication.category:DkTmCategory	example	CommunicationCategory http://hl7.org/fhir/ValueSet/communication-category from the FHIR Standard
Communication.medium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.medium:DkTmMedium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.reasonCode	required	eHealth Message Reason Code http://ehealth.sundhed.dk/vs/message-reasonCode from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
advice-invariant	error	Communication	Category advice invariant : category.coding.code = 'advice' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())
message-invariant	error	Communication	Category message invariant : category.coding.code = 'message' implies (recipient.reference.contains('Patient/') and ( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists())) or (( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and (sender.reference.contains('Patient/')) or (extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists() ))
nemsms-invariant	error	Communication	If communication resource is a NemSMS payload cannot exceed 160 : medium.coding.where(code = 'nemsms').exists() implies payload.contentString.length() <= 160
note-invariant	error	Communication	Category note invariant : category.coding.code = 'note' implies (sender.reference = recipient.reference) or (recipient.reference.exists().not() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists())
notification-invariant	error	Communication	Category notification invariant : category.coding.code = 'notification' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())

Name	Flags	Card.	Type	Description & Constraints
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver nemsms-invariant: If communication resource is a NemSMS payload cannot exceed 160 note-invariant: Category note invariant notification-invariant: Category notification invariant message-invariant: Category message invariant advice-invariant: Category advice invariant
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
episodeOfCare		0..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
recipientCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam
senderCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message sender URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam
restrictionCategory		0..*	CodeableConcept	Restriction category URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-restriction-category Binding: Restriction Category (required)
threadId		0..1	string	Thread id URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-thread-id
period		0..*	Period	Specifies the temporal validity of an ehealth/message instance URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-period
administrativeStatus		1..1	Coding	The administrative status of how a message recipient has handled a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-administrative-status Binding: Administrative Status (required)
title		0..1	string	Message title URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-title
priority		0..1	code	The priority of a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-priority Binding: Priority (required)
groupId		0..1	string	Logical id identifying a set of messages with the same recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-group-id
onBehalfOf	S	0..1	Reference(ehealth-careteam) {r}	On behalf of URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-on-behalf-of
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Unique identifier
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(Resource)	Request fulfilled by this communication
partOf	Σ	0..*	Reference(CarePlan) {r}	Part of this action
inResponseTo		0..*	Reference(Communication)	Reply to
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): The status of the communication.
statusReason	Σ	0..1	CodeableConcept	Reason for current status Binding: CommunicationNotDoneReason (example): Codes for the reason why a communication did not happen.
Slices for category		1..*	CodeableConcept	Message category Slice: Unordered, Open by value:coding.system Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
category:DkTmCategory		1..1	CodeableConcept	Message category Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://ehealth.sundhed.dk/cs/message-category
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Binding: MessageCategory (required)
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Codes indicating the relative importance of a communication.
Slices for medium		0..*	CodeableConcept	A channel of communication Slice: Unordered, Open by value:coding.system Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
medium:DkTmMedium		0..1	CodeableConcept	A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://ehealth.sundhed.dk/cs/message-medium
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Binding: MessageMedium (required)
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	0..1	Reference(Patient | Group)	Focus of message
topic		0..1	CodeableConcept	Description of the purpose/content Binding: CommunicationTopic (example): Codes describing the purpose or content of the communication.
about		0..*	Reference(Resource)	Resources that pertain to this communication
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
sent		0..1	dateTime	When sent
received		0..1	dateTime	When received
recipient		0..1	Reference(Patient | Practitioner) {r}	Message recipient
sender		0..1	Reference(Device | Patient | Practitioner) {r, c}	Message sender
reasonCode	Σ	0..*	CodeableConcept	Indication for message Binding: eHealth Message Reason Code (required)
reasonReference	Σ	0..*	Reference(Condition | Observation) {r}	Why was communication done?
payload		0..1	BackboneElement	Message payload
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for content[x]		1..1	string	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentString		1..1	string	Message part content
note		0..*	Annotation	Comments made about the communication
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for author[x]	Σ	0..1		Individual responsible for the annotation Slice: Unordered, Closed by type:$this
authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
authorString			string
author[x]:authorReference	Σ	0..1	Reference(ehealth-practitioner | ehealth-patient | ehealth-relatedperson)	Individual responsible for the annotation
author[x]:authorString	Σ	0..1	string	Individual responsible for the annotation
time	Σ	0..1	dateTime	When the annotation was made
text	Σ	1..1	markdown	The annotation - text content (as markdown)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Communication.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Communication.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 from the FHIR Standard
Communication.statusReason	example	CommunicationNotDoneReason http://hl7.org/fhir/ValueSet/communication-not-done-reason from the FHIR Standard
Communication.category	example	CommunicationCategory http://hl7.org/fhir/ValueSet/communication-category from the FHIR Standard
Communication.category:DkTmCategory	example	CommunicationCategory http://hl7.org/fhir/ValueSet/communication-category from the FHIR Standard
Communication.category:DkTmCategory.coding.code	required	MessageCategory http://ehealth.sundhed.dk/vs/message-category from this IG
Communication.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
Communication.medium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.medium:DkTmMedium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.medium:DkTmMedium.coding.code	required	MessageMedium http://ehealth.sundhed.dk/vs/message-medium from this IG
Communication.topic	example	CommunicationTopic http://hl7.org/fhir/ValueSet/communication-topic from the FHIR Standard
Communication.reasonCode	required	eHealth Message Reason Code http://ehealth.sundhed.dk/vs/message-reasonCode from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
advice-invariant	error	Communication	Category advice invariant : category.coding.code = 'advice' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())
message-invariant	error	Communication	Category message invariant : category.coding.code = 'message' implies (recipient.reference.contains('Patient/') and ( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists())) or (( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and (sender.reference.contains('Patient/')) or (extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists() ))
nemsms-invariant	error	Communication	If communication resource is a NemSMS payload cannot exceed 160 : medium.coding.where(code = 'nemsms').exists() implies payload.contentString.length() <= 160
note-invariant	error	Communication	Category note invariant : category.coding.code = 'note' implies (sender.reference = recipient.reference) or (recipient.reference.exists().not() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists())
notification-invariant	error	Communication	Category notification invariant : category.coding.code = 'notification' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())

Differential View

This structure is derived from Communication

Name	Flags	Card.	Type	Description & Constraints
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver nemsms-invariant: If communication resource is a NemSMS payload cannot exceed 160 note-invariant: Category note invariant notification-invariant: Category notification invariant message-invariant: Category message invariant advice-invariant: Category advice invariant
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
episodeOfCare		0..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
recipientCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam
senderCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message sender URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam
restrictionCategory		0..*	CodeableConcept	Restriction category URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-restriction-category Binding: Restriction Category (required)
threadId		0..1	string	Thread id URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-thread-id
period		0..*	Period	Specifies the temporal validity of an ehealth/message instance URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-period
administrativeStatus		1..1	Coding	The administrative status of how a message recipient has handled a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-administrative-status Binding: Administrative Status (required)
title		0..1	string	Message title URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-title
priority		0..1	code	The priority of a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-priority Binding: Priority (required)
groupId		0..1	string	Logical id identifying a set of messages with the same recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-group-id
onBehalfOf	S	0..1	Reference(ehealth-careteam) {r}	On behalf of URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-on-behalf-of
partOf		0..*	Reference(CarePlan) {r}	Part of this action
Slices for category		1..*	CodeableConcept	Message category Slice: Unordered, Open by value:coding.system
category:DkTmCategory		1..1	CodeableConcept	Message category
coding
system		1..1	uri	Identity of the terminology system Required Pattern: http://ehealth.sundhed.dk/cs/message-category
code		0..1	code	Symbol in syntax defined by the system Binding: MessageCategory (required)
Slices for medium		0..*	CodeableConcept	A channel of communication Slice: Unordered, Open by value:coding.system
medium:DkTmMedium		0..1	CodeableConcept	A channel of communication
coding
system		1..1	uri	Identity of the terminology system Required Pattern: http://ehealth.sundhed.dk/cs/message-medium
code		0..1	code	Symbol in syntax defined by the system Binding: MessageMedium (required)
recipient		0..1	Reference(Patient | Practitioner) {r}	Message recipient
sender		0..1	Reference(Device | Patient | Practitioner) {r, c}	Message sender
reasonCode		0..*	CodeableConcept	Indication for message Binding: eHealth Message Reason Code (required)
reasonReference		0..*	Reference(Condition | Observation) {r}	Why was communication done?
payload		0..1	BackboneElement	Message payload
Slices for content[x]		1..1	string	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentString		1..1	string	Message part content
note
Slices for author[x]		0..1	Reference(Practitioner | Patient | RelatedPerson | Organization), string	Individual responsible for the annotation Slice: Unordered, Open by type:$this
author[x]:authorReference		0..1	Reference(ehealth-practitioner | ehealth-patient | ehealth-relatedperson)	Individual responsible for the annotation
author[x]:authorString		0..1	string	Individual responsible for the annotation
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Communication.category:DkTmCategory.coding.code	required	MessageCategory http://ehealth.sundhed.dk/vs/message-category from this IG
Communication.medium:DkTmMedium.coding.code	required	MessageMedium http://ehealth.sundhed.dk/vs/message-medium from this IG
Communication.reasonCode	required	eHealth Message Reason Code http://ehealth.sundhed.dk/vs/message-reasonCode from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
advice-invariant	error	Communication	Category advice invariant : category.coding.code = 'advice' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())
message-invariant	error	Communication	Category message invariant : category.coding.code = 'message' implies (recipient.reference.contains('Patient/') and ( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists())) or (( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and (sender.reference.contains('Patient/')) or (extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists() ))
nemsms-invariant	error	Communication	If communication resource is a NemSMS payload cannot exceed 160 : medium.coding.where(code = 'nemsms').exists() implies payload.contentString.length() <= 160
note-invariant	error	Communication	Category note invariant : category.coding.code = 'note' implies (sender.reference = recipient.reference) or (recipient.reference.exists().not() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists())
notification-invariant	error	Communication	Category notification invariant : category.coding.code = 'notification' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver nemsms-invariant: If communication resource is a NemSMS payload cannot exceed 160 note-invariant: Category note invariant notification-invariant: Category notification invariant message-invariant: Category message invariant advice-invariant: Category advice invariant
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
episodeOfCare		0..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
recipientCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam
senderCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message sender URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam
restrictionCategory		0..*	CodeableConcept	Restriction category URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-restriction-category Binding: Restriction Category (required)
threadId		0..1	string	Thread id URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-thread-id
period		0..*	Period	Specifies the temporal validity of an ehealth/message instance URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-period
administrativeStatus		1..1	Coding	The administrative status of how a message recipient has handled a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-administrative-status Binding: Administrative Status (required)
title		0..1	string	Message title URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-title
priority		0..1	code	The priority of a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-priority Binding: Priority (required)
groupId		0..1	string	Logical id identifying a set of messages with the same recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-group-id
onBehalfOf	S	0..1	Reference(ehealth-careteam) {r}	On behalf of URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-on-behalf-of
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
partOf	Σ	0..*	Reference(CarePlan) {r}	Part of this action
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): The status of the communication.
Slices for category		1..*	CodeableConcept	Message category Slice: Unordered, Open by value:coding.system Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
category:DkTmCategory		1..1	CodeableConcept	Message category Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
Slices for medium		0..*	CodeableConcept	A channel of communication Slice: Unordered, Open by value:coding.system Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
medium:DkTmMedium		0..1	CodeableConcept	A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
recipient		0..1	Reference(Patient | Practitioner) {r}	Message recipient
sender		0..1	Reference(Device | Patient | Practitioner) {r, c}	Message sender
reasonCode	Σ	0..*	CodeableConcept	Indication for message Binding: eHealth Message Reason Code (required)
reasonReference	Σ	0..*	Reference(Condition | Observation) {r}	Why was communication done?
payload		0..1	BackboneElement	Message payload
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for content[x]		1..1	string	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentString		1..1	string	Message part content
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Communication.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 from the FHIR Standard
Communication.category	example	CommunicationCategory http://hl7.org/fhir/ValueSet/communication-category from the FHIR Standard
Communication.category:DkTmCategory	example	CommunicationCategory http://hl7.org/fhir/ValueSet/communication-category from the FHIR Standard
Communication.medium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.medium:DkTmMedium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.reasonCode	required	eHealth Message Reason Code http://ehealth.sundhed.dk/vs/message-reasonCode from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
advice-invariant	error	Communication	Category advice invariant : category.coding.code = 'advice' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())
message-invariant	error	Communication	Category message invariant : category.coding.code = 'message' implies (recipient.reference.contains('Patient/') and ( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists())) or (( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and (sender.reference.contains('Patient/')) or (extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists() ))
nemsms-invariant	error	Communication	If communication resource is a NemSMS payload cannot exceed 160 : medium.coding.where(code = 'nemsms').exists() implies payload.contentString.length() <= 160
note-invariant	error	Communication	Category note invariant : category.coding.code = 'note' implies (sender.reference = recipient.reference) or (recipient.reference.exists().not() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists())
notification-invariant	error	Communication	Category notification invariant : category.coding.code = 'notification' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver nemsms-invariant: If communication resource is a NemSMS payload cannot exceed 160 note-invariant: Category note invariant notification-invariant: Category notification invariant message-invariant: Category message invariant advice-invariant: Category advice invariant
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
episodeOfCare		0..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
recipientCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam
senderCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message sender URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam
restrictionCategory		0..*	CodeableConcept	Restriction category URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-restriction-category Binding: Restriction Category (required)
threadId		0..1	string	Thread id URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-thread-id
period		0..*	Period	Specifies the temporal validity of an ehealth/message instance URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-period
administrativeStatus		1..1	Coding	The administrative status of how a message recipient has handled a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-administrative-status Binding: Administrative Status (required)
title		0..1	string	Message title URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-title
priority		0..1	code	The priority of a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-priority Binding: Priority (required)
groupId		0..1	string	Logical id identifying a set of messages with the same recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-group-id
onBehalfOf	S	0..1	Reference(ehealth-careteam) {r}	On behalf of URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-on-behalf-of
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Unique identifier
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(Resource)	Request fulfilled by this communication
partOf	Σ	0..*	Reference(CarePlan) {r}	Part of this action
inResponseTo		0..*	Reference(Communication)	Reply to
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): The status of the communication.
statusReason	Σ	0..1	CodeableConcept	Reason for current status Binding: CommunicationNotDoneReason (example): Codes for the reason why a communication did not happen.
Slices for category		1..*	CodeableConcept	Message category Slice: Unordered, Open by value:coding.system Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
category:DkTmCategory		1..1	CodeableConcept	Message category Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://ehealth.sundhed.dk/cs/message-category
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Binding: MessageCategory (required)
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Codes indicating the relative importance of a communication.
Slices for medium		0..*	CodeableConcept	A channel of communication Slice: Unordered, Open by value:coding.system Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
medium:DkTmMedium		0..1	CodeableConcept	A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://ehealth.sundhed.dk/cs/message-medium
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Binding: MessageMedium (required)
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	0..1	Reference(Patient | Group)	Focus of message
topic		0..1	CodeableConcept	Description of the purpose/content Binding: CommunicationTopic (example): Codes describing the purpose or content of the communication.
about		0..*	Reference(Resource)	Resources that pertain to this communication
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
sent		0..1	dateTime	When sent
received		0..1	dateTime	When received
recipient		0..1	Reference(Patient | Practitioner) {r}	Message recipient
sender		0..1	Reference(Device | Patient | Practitioner) {r, c}	Message sender
reasonCode	Σ	0..*	CodeableConcept	Indication for message Binding: eHealth Message Reason Code (required)
reasonReference	Σ	0..*	Reference(Condition | Observation) {r}	Why was communication done?
payload		0..1	BackboneElement	Message payload
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for content[x]		1..1	string	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentString		1..1	string	Message part content
note		0..*	Annotation	Comments made about the communication
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for author[x]	Σ	0..1		Individual responsible for the annotation Slice: Unordered, Closed by type:$this
authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
authorString			string
author[x]:authorReference	Σ	0..1	Reference(ehealth-practitioner | ehealth-patient | ehealth-relatedperson)	Individual responsible for the annotation
author[x]:authorString	Σ	0..1	string	Individual responsible for the annotation
time	Σ	0..1	dateTime	When the annotation was made
text	Σ	1..1	markdown	The annotation - text content (as markdown)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Communication.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Communication.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 from the FHIR Standard
Communication.statusReason	example	CommunicationNotDoneReason http://hl7.org/fhir/ValueSet/communication-not-done-reason from the FHIR Standard
Communication.category	example	CommunicationCategory http://hl7.org/fhir/ValueSet/communication-category from the FHIR Standard
Communication.category:DkTmCategory	example	CommunicationCategory http://hl7.org/fhir/ValueSet/communication-category from the FHIR Standard
Communication.category:DkTmCategory.coding.code	required	MessageCategory http://ehealth.sundhed.dk/vs/message-category from this IG
Communication.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
Communication.medium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.medium:DkTmMedium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.medium:DkTmMedium.coding.code	required	MessageMedium http://ehealth.sundhed.dk/vs/message-medium from this IG
Communication.topic	example	CommunicationTopic http://hl7.org/fhir/ValueSet/communication-topic from the FHIR Standard
Communication.reasonCode	required	eHealth Message Reason Code http://ehealth.sundhed.dk/vs/message-reasonCode from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
advice-invariant	error	Communication	Category advice invariant : category.coding.code = 'advice' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())
message-invariant	error	Communication	Category message invariant : category.coding.code = 'message' implies (recipient.reference.contains('Patient/') and ( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists())) or (( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and (sender.reference.contains('Patient/')) or (extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists() ))
nemsms-invariant	error	Communication	If communication resource is a NemSMS payload cannot exceed 160 : medium.coding.where(code = 'nemsms').exists() implies payload.contentString.length() <= 160
note-invariant	error	Communication	Category note invariant : category.coding.code = 'note' implies (sender.reference = recipient.reference) or (recipient.reference.exists().not() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists())
notification-invariant	error	Communication	Category notification invariant : category.coding.code = 'notification' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())

This structure is derived from Communication

Summary

Mandatory: 4 elements (3 nested mandatory elements)
Must-Support: 1 element

Structures

This structure refers to these other structures:

• ehealth-practitioner (http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-practitioner)
• ehealth-patient (http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-patient)
• ehealth-relatedperson (http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-relatedperson)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-restriction-category
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-thread-id
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-period
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-administrative-status
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-title
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-priority
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-group-id
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-on-behalf-of

Slices

This structure defines the following Slices:

• The element Communication.category is sliced based on the value of value:coding.system
• The element Communication.medium is sliced based on the value of value:coding.system
• The element Communication.payload.content[x] is sliced based on the value of type:$this (Closed)
• The element Communication.note.author[x] is sliced based on the value of type:$this