HL7® FHIR® New Zealand Base Implementation Guide
3.0.1

HL7® FHIR® New Zealand Base Implementation Guide, published by HL7 New Zealand

Resource Profile: NzPractitioner - Detailed Descriptions

Draft as of 2024-08-14

Definitions for the NzPractitioner resource profile.

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

0. Practitioner
2. Practitioner.extension
SlicingThis element introduces a set of slices on Practitioner.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Practitioner.extension:death-date
    Slice Namedeath-date
    Control0..1
    TypeExtension(Date of death) (Complex Extension)
    6. Practitioner.extension:educational-qualification
    Slice Nameeducational-qualification
    Control0..*
    TypeExtension(EducationalQualification) (Complex Extension)
    8. Practitioner.extension:ethnicity
    Slice Nameethnicity
    Control0..*
    TypeExtension(NZ Ethnicity) (Extension Type: CodeableConcept)
    10. Practitioner.extension:iwi
    Slice Nameiwi
    Control0..*
    TypeExtension(Nz_iwi) (Extension Type: CodeableConcept)
    12. Practitioner.extension:messaging-address
    Slice Namemessaging-address
    Control0..*
    TypeExtension(Messaging Address) (Complex Extension)
    14. Practitioner.qualification
    16. Practitioner.qualification.extension
    SlicingThis element introduces a set of slices on Practitioner.qualification.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 18. Practitioner.qualification.extension:additional-authorisation
      Slice Nameadditional-authorisation
      Control0..*
      TypeExtension(AdditionalAuthorisation) (Complex Extension)
      20. Practitioner.qualification.extension:condition-on-practice
      Slice Namecondition-on-practice
      Control0..*
      TypeExtension(ConditionOnPractice) (Complex Extension)
      22. Practitioner.qualification.extension:registration-initial-date
      Slice Nameregistration-initial-date
      Control0..1
      TypeExtension(RegistrationInitialDate) (Extension Type: date)
      24. Practitioner.qualification.extension:registration-status-code
      Slice Nameregistration-status-code
      Control0..1
      TypeExtension(RegistrationStatusCode) (Complex Extension)
      26. Practitioner.qualification.extension:scope-of-practice
      Slice Namescope-of-practice
      Control0..*
      TypeExtension(ScopeOfPractice) (Complex Extension)

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

      0. Practitioner
      Definition

      A person who is directly or indirectly involved in the provisioning of healthcare.

      ShortA person with a formal responsibility in the provisioning of healthcare or related services
      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. Practitioner.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

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

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      4. Practitioner.extension
      Definition

      An Extension


      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.

      ShortExtensionAdditional content defined by implementations
      Comments

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

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

        The date of death of the individual, plus the source of that information

        ShortDate of death
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Date of death) (Complex Extension)
        Is Modifierfalse
        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())
        8. Practitioner.extension:educational-qualification
        Slice Nameeducational-qualification
        Definition

        Educational qualifications a practitioner has. These may or may not be related to registration information.

        ShortExtension
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(EducationalQualification) (Complex Extension)
        Is Modifierfalse
        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())
        10. Practitioner.extension:ethnicity
        Slice Nameethnicity
        Definition

        The ethnic group or groups that a person identifies with or feels they belong to. Ethnicity is a measure of cultural affiliation as opposed to race, ancestry, nationality or citizen. Ethnicity is self-perceived and a person can belong to more than one group.

        The Stats New Zealand standard can be found here.

        ShortNZ Ethnicity
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(NZ Ethnicity) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        12. Practitioner.extension:iwi
        Slice Nameiwi
        Definition

        Persons Iwi affiliation

        ShortExtension
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(Nz_iwi) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        14. Practitioner.extension:messaging-address
        Slice Namemessaging-address
        Definition

        The address to where electronic communications might be sent. For historical reasons, there is an overlap with edi-address.

        ShortMessaging Address
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(Messaging Address) (Complex Extension)
        Is Modifierfalse
        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. Practitioner.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())

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

        0. Practitioner
        Definition

        A person who is directly or indirectly involved in the provisioning of healthcare.

        ShortA person with a formal responsibility in the provisioning of healthcare or related services
        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. Practitioner.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. Practitioner.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. Practitioner.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. Practitioner.language
        Definition

        The base language in which the resource is written.

        ShortLanguage of the resource content
        Comments

        Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

        Control0..1
        BindingThe codes SHOULD be taken from CommonLanguages
        (preferred to http://hl7.org/fhir/ValueSet/languages)

        A human language.

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

        An Extension

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

          The date of death of the individual, plus the source of that information

          ShortDate of death
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Date of death) (Complex Extension)
          Is Modifierfalse
          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. Practitioner.extension:educational-qualification
          Slice Nameeducational-qualification
          Definition

          Educational qualifications a practitioner has. These may or may not be related to registration information.

          ShortExtension
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(EducationalQualification) (Complex Extension)
          Is Modifierfalse
          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())
          20. Practitioner.extension:ethnicity
          Slice Nameethnicity
          Definition

          The ethnic group or groups that a person identifies with or feels they belong to. Ethnicity is a measure of cultural affiliation as opposed to race, ancestry, nationality or citizen. Ethnicity is self-perceived and a person can belong to more than one group.

          The Stats New Zealand standard can be found here.

          ShortNZ Ethnicity
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(NZ Ethnicity) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          22. Practitioner.extension:iwi
          Slice Nameiwi
          Definition

          Persons Iwi affiliation

          ShortExtension
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(Nz_iwi) (Extension Type: CodeableConcept)
          Is Modifierfalse
          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())
          24. Practitioner.extension:messaging-address
          Slice Namemessaging-address
          Definition

          The address to where electronic communications might be sent. For historical reasons, there is an overlap with edi-address.

          ShortMessaging Address
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(Messaging Address) (Complex Extension)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          26. Practitioner.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())
          28. Practitioner.identifier
          Definition

          An identifier that applies to this person in this role.

          ShortAn identifier for the person as this agent
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          TypeIdentifier
          Is Modifierfalse
          Summarytrue
          Requirements

          Often, specific identities are assigned for the agent.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          30. Practitioner.active
          Definition

          Whether this practitioner's record is in active use.

          ShortWhether this practitioner's record is in active use
          Comments

          If the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role.

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

          Need to be able to mark a practitioner record as not to be used because it was created in error.

          Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          32. Practitioner.name
          Definition

          The name(s) associated with the practitioner.

          ShortThe name(s) associated with the practitioner
          Comments

          The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate.

          In general, select the value to be used in the ResourceReference.display based on this:

          1. There is more than 1 name
          2. Use = usual
          3. Period is current to the date of the usage
          4. Use = official
          5. Other order as decided by internal business rules.
          Control0..*
          TypeHumanName
          Is Modifierfalse
          Summarytrue
          Requirements

          The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          34. Practitioner.telecom
          Definition

          A contact detail for the practitioner, e.g. a telephone number or an email address.

          ShortA contact detail for the practitioner (that apply to all roles)
          Comments

          Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and to help with identification. These typically will have home numbers, or mobile numbers that are not role specific.

          Control0..*
          TypeContactPoint
          Is Modifierfalse
          Summarytrue
          Requirements

          Need to know how to reach a practitioner independent to any roles the practitioner may have.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          36. Practitioner.address
          Definition

          Address(es) of the practitioner that are not role specific (typically home address). Work addresses are not typically entered in this property as they are usually role dependent.

          ShortAddress(es) of the practitioner that are not role specific (typically home address)
          Comments

          The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).

          Control0..*
          TypeAddress
          Is Modifierfalse
          Summarytrue
          Requirements

          The home/mailing address of the practitioner is often required for employee administration purposes, and also for some rostering services where the start point (practitioners home) can be used in calculations.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          38. Practitioner.gender
          Definition

          Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes.

          Shortmale | female | other | unknown
          Control0..1
          BindingThe codes SHALL be taken from AdministrativeGender
          (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

          The gender of a person used for administrative purposes.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Needed to address the person correctly.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          40. Practitioner.birthDate
          Definition

          The date of birth for the practitioner.

          ShortThe date on which the practitioner was born
          Control0..1
          Typedate
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Needed for identification.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. Practitioner.photo
          Definition

          Image of the person.

          ShortImage of the person
          Control0..*
          TypeAttachment
          Is Modifierfalse
          Summaryfalse
          Requirements

          Many EHR systems have the capability to capture an image of patients and personnel. Fits with newer social media usage too.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. Practitioner.qualification
          Definition

          The official certifications, training, and licenses that authorize or otherwise pertain to the provision of care by the practitioner. For example, a medical license issued by a medical board authorizing the practitioner to practice medicine within a certian locality.

          ShortCertification, licenses, or training pertaining to the provision of care
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. Practitioner.qualification.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. Practitioner.qualification.extension
          Definition

          An Extension

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

            Additional authorisations that a practitioner is authorised to perform in addition to their registration and scope of practice. Examples include:

            • Prescribing authorisation for a nurse practitioner
            • Authorisation to administer immunisations
            ShortExtension
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(AdditionalAuthorisation) (Complex Extension)
            Is Modifierfalse
            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. Practitioner.qualification.extension:condition-on-practice
            Slice Namecondition-on-practice
            Definition

            A full description of the conditions the health practitioner is subject to in relation to their scope of practice.

            ShortExtension
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(ConditionOnPractice) (Complex Extension)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            54. Practitioner.qualification.extension:registration-initial-date
            Slice Nameregistration-initial-date
            Definition

            The date the practitioner first became registered with the Responsible Authority or professional body

            ShortExtension
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(RegistrationInitialDate) (Extension Type: date)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            56. Practitioner.qualification.extension:registration-status-code
            Slice Nameregistration-status-code
            Definition

            An indicator of the practicing status of the practitioner as supplied by their Responsible Authority or professional body.

            ShortExtension
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(RegistrationStatusCode) (Complex Extension)
            Is Modifierfalse
            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())
            58. Practitioner.qualification.extension:scope-of-practice
            Slice Namescope-of-practice
            Definition

            The type or range of health services a practitioner is authorised to perform, as determined by the Responsible Authority or professional body.

            ShortExtension
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(ScopeOfPractice) (Complex Extension)
            Is Modifierfalse
            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())
            60. Practitioner.qualification.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())
            62. Practitioner.qualification.identifier
            Definition

            An identifier that applies to this person's qualification in this role.

            ShortAn identifier for this qualification for the practitioner
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier
            Is Modifierfalse
            Summaryfalse
            Requirements

            Often, specific identities are assigned for the qualification.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            64. Practitioner.qualification.code
            Definition

            Coded representation of the qualification.

            ShortCoded representation of the qualification
            Control1..1
            BindingFor example codes, see v2 table 0360, Version 2.7
            (example to http://terminology.hl7.org/ValueSet/v2-2.7-0360)

            Specific qualification the practitioner has to provide a service.

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            66. Practitioner.qualification.period
            Definition

            Period during which the qualification is valid.

            ShortPeriod during which the qualification is valid
            Control0..1
            TypePeriod
            Is Modifierfalse
            Summaryfalse
            Requirements

            Qualifications are often for a limited period of time, and can be revoked.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            68. Practitioner.qualification.issuer
            Definition

            Organization that regulates and issues the qualification.

            ShortOrganization that regulates and issues the qualification
            Control0..1
            TypeReference(Organization)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            70. Practitioner.communication
            Definition

            A language the practitioner can use in patient communication.

            ShortA language the practitioner can use in patient communication
            Comments

            The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

            Control0..*
            BindingThe codes SHOULD be taken from CommonLanguages
            (preferred to http://hl7.org/fhir/ValueSet/languages)

            A human language.

            Additional BindingsPurpose
            AllLanguagesMax Binding
            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Requirements

            Knowing which language a practitioner speaks can help in facilitating communication with patients.

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