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RARecord Profiles

This page describes Resource and Profile StructureDefinitions required to support data transmission within the FHIR® Reasonable Adjustments API.

RARecord-Flag-1

RARecord-Flag-1 XML Example

<?xml version="1.0" encoding="utf-8"?>
<Flag xmlns="http://hl7.org/fhir">
    <id value="5f96eae1-b5eb-439d-8ba3-153c2b99698c"/>
    <meta>
        <versionId value="0dd8da0f-2902-4604-bf87-7268e1ce8166"/>
        <lastUpdated value="2016-03-01T10:04:33+00:00"/>
        <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Flag-1"/>
    </meta>
    <contained>
            <Provenance>
                <id value="2c4aa85d-4489-4399-9d3c-35a10a1e6ef1"/>
                <meta>
                    <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"/>
                </meta>
                <target>
                    <reference value="Flag/5f96eae1-b5eb-439d-8ba3-153c2b99698c"/>
                </target>
                <recorded value="2016-03-01T10:05:33+00:00"/>
                <agent>
                    <role>
                        <coding>
                            <system value="https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1"/>
                            <code value="R0260"/>
                            <display value="General Medical Practitioner"/>
                        </coding>
                    </role>
                    <whoReference>
                        <reference value="https://sds.spineservices.nhs.uk/STU3/Practitioner/2ee4tr6a9"/>
                        <display value="Dr.D"/>
                    </whoReference>
                    <onBehalfOfReference>
                        <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7"/>
                        <display value="Some GP Clinic"/>
                    </onBehalfOfReference>
                </agent>
            </Provenance>
    </contained>
    <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1">
        <extension url="created">
            <valueReference>
                <reference value="#2c4aa85d-4489-4399-9d3c-35a10a1e6ef1"/>
            </valueReference>
        </extension>
    </extension>
    <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-AdjustmentCategory-1">
        <valueCodeableConcept>
            <coding>
                <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AdjustmentCategories-1"/>
                <code value="comms"/>
                <display value="Communication"/>
            </coding>
        </valueCodeableConcept>
    </extension>
    <status value="active"/>
    <category>
        <coding>
            <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-FlagCategory-1"/>
            <code value="reasonable adjustments flag"/>
            <display value="Reasonable Adjustments Flag"/>
        </coding>
    </category>
    <code>
        <coding>
            <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AccessibleInformationAdjustments-1"/>
            <code value="requiresinformationineasyread"/>
            <display value="Requires information in Easyread"/>
        </coding>
    </code>
    <subject>
        <identifier>
            <reference value="demographics.spineservices.nhs.uk/STU3/Patient/999999998"/>
        </identifier>
    </subject>
</Flag>

RARecord-Flag-1 JSON Example

{
  "resourceType": "Flag",
  "id": "5f96eae1-b5eb-439d-8ba3-153c2b99698c",
  "meta": {
    "versionId": "0dd8da0f-2902-4604-bf87-7268e1ce8166",
    "lastUpdated": "2016-03-01T10:04:33+00:00",
    "profile": [
      "https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Flag-1"
    ]
  },
  "contained": [
    {
      "resourceType": "Provenance",
      "id": "2c4aa85d-4489-4399-9d3c-35a10a1e6ef1",
      "meta": {
        "profile": [
          "https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"
        ]
      },
      "target": [
        {
          "reference": "Flag/5f96eae1-b5eb-439d-8ba3-153c2b99698c"
        }
      ],
      "recorded": "2016-03-01T10:05:33+00:00",
      "agent": [
        {
          "role": [
            {
              "coding": [
                {
                  "system": "https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1",
                  "code": "R0260",
                  "display": "General Medical Practitioner"
                }
              ]
            }
          ],
          "whoReference": {
            "reference": "https://sds.spineservices.nhs.uk/STU3/Practitioner/2ee4tr6a9",
            "display": "Dr.D"
          },
          "onBehalfOfReference": {
            "reference": "https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7",
            "display": "Some GP Clinic"
          }
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1",
      "extension": [
        {
          "url": "created",
          "valueReference": {
            "reference": "#2c4aa85d-4489-4399-9d3c-35a10a1e6ef1"
          }
        }
      ]
    },
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-AdjustmentCategory-1",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AdjustmentCategories-1",
            "code": "comms",
            "display": "Communication"
          }
        ]
      }
    }
  ],
  "status": "active",
  "category": {
    "coding": [
      {
        "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-FlagCategory-1",
        "code": "reasonable adjustments flag",
        "display": "Reasonable Adjustments Flag"
      }
    ]
  },
  "code": {
    "coding": [
      {
        "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AccessibleInformationAdjustments-1",
        "code": "requiresinformationineasyread",
        "display": "Requires information in Easyread"
      }
    ]
  }
}

<?xml version="1.0" encoding="utf-8"?>
<!-- RARecord-Consent-1 example using a Legal Proxy -->
<Consent xmlns="http://hl7.org/fhir">
    <id value="f1dc0ac6-45ff-4d2b-bf91-793971e3e286"/>
    <meta>
        <versionId value="2c8cab29-db54-4ae7-8135-5de94807f2d9"/>
        <lastUpdated value="2016-03-01T10:04:33+00:00"/>
        <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Consent-1"/>
    </meta>
    <contained>
            <Provenance>
                <id value="e0531fd1-212d-4a97-a7a9-d17cec9a6af2"/>
                <meta>
                    <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"/>
                </meta>
                <target>
                    <reference value="Consent/f1dc0ac6-45ff-4d2b-bf91-793971e3e286"/>
                </target>
                <recorded value="2016-03-01T10:05:33+00:00"/>
                <agent>
                    <role>
                        <coding>
                            <system value="https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1"/>
                            <code value="R0260"/>
                            <display value="General Medical Practitioner"/>
                        </coding>
                    </role>
                    <whoReference>
                        <reference value="https://sds.spineservices.nhs.uk/STU3/Practitioner/2ee4tr6a9"/>
                        <display value="Dr.D"/>
                    </whoReference>
                    <onBehalfOfReference>
                        <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7"/>
                        <display value="Some GP Clinic"/>
                    </onBehalfOfReference>
                </agent>
            </Provenance>
        </contained>
    <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-ProxyRole-1">
        <valueCodeableConcept>
            <coding>
                <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-ProxyRole-1"/>
                <code value="lpa"/>
                <display value="Lasting power of attorney personal welfare"/>
            </coding>
        </valueCodeableConcept>
    </extension>
    <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1">
        <extension url="created">
            <valueReference>
                <reference value="#e0531fd1-212d-4a97-a7a9-d17cec9a6af2"/>
            </valueReference>
        </extension>
    </extension>
    <status value="active"/>
    <category>
        <coding>
            <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-FlagCategory-1"/>
            <code value="reasonable adjustments flag"/>
            <display value="Reasonable Adjustments Flag"/>
        </coding>
    </category>
    <patient>
        <identifier>
            <reference value="demographics.spineservices.nhs.uk/STU3/Patient/999999998"/>
        </identifier>
    </patient>
    <!-- these are directly lifted from National Data Opt Out. Will need either a general set or specific values for Reasonable Adjustments -->
    <policy>
        <authority value="https://www.gov.uk/"/>
        <uri value="https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/535024/data-security-review.pdf"/>
    </policy>
    <purpose>
        <system value="https://snomed.info/sct"/>
        <code value="370856009"/>
        <display value="Limiting access to confidential patient information"/>
    </purpose>
</Consent>


{
  "resourceType": "Consent",
  "id": "f1dc0ac6-45ff-4d2b-bf91-793971e3e286",
  "fhir_comments": [
    " RARecord-Consent-1 example using a Legal Proxy "
  ],
  "meta": {
    "versionId": "2c8cab29-db54-4ae7-8135-5de94807f2d9",
    "lastUpdated": "2016-03-01T10:04:33+00:00",
    "profile": [
      "https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Consent-1"
    ]
  },
  "contained": [
    {
      "resourceType": "Provenance",
      "id": "e0531fd1-212d-4a97-a7a9-d17cec9a6af2",
      "meta": {
        "profile": [
          "https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"
        ]
      },
      "target": [
        {
          "reference": "Consent/f1dc0ac6-45ff-4d2b-bf91-793971e3e286"
        }
      ],
      "recorded": "2016-03-01T10:05:33+00:00",
      "agent": [
        {
          "role": [
            {
              "coding": [
                {
                  "system": "https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1",
                  "code": "R0260",
                  "display": "General Medical Practitioner"
                }
              ]
            }
          ],
          "whoReference": {
            "reference": "https://sds.spineservices.nhs.uk/STU3/Practitioner/2ee4tr6a9",
            "display": "Dr.D"
          },
          "onBehalfOfReference": {
            "reference": "https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7",
            "display": "Some GP Clinic"
          }
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-ProxyRole-1",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-ProxyRole-1",
            "code": "lpa",
            "display": "Lasting power of attorney personal welfare"
          }
        ]
      }
    },
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1",
      "extension": [
        {
          "url": "created",
          "valueReference": {
            "reference": "#e0531fd1-212d-4a97-a7a9-d17cec9a6af2"
          }
        }
      ]
    }
  ],
  "status": "active",
  "category": [
    {
      "coding": [
        {
          "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-FlagCategory-1",
          "code": "reasonable adjustments flag",
          "display": "Reasonable Adjustments Flag"
        }
      ]
    }
  ],
  "policy": [
    {
      "fhir_comments": [
        " these are directly lifted from National Data Opt Out. Will need either a general set or specific values for Reasonable Adjustments "
      ],
      "authority": "https://www.gov.uk/",
      "uri": "https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/535024/data-security-review.pdf"
    }
  ],
  "purpose": [
    {
      "system": "https://snomed.info/sct",
      "code": "370856009",
      "display": "Limiting access to confidential patient information"
    }
  ]
}

CareConnect-RARecord-Condition-1

CareConnect-RARecord-Condition-1 XML Example

<?xml version="1.0" encoding="utf-8"?>
<Condition xmlns="http://hl7.org/fhir">
    <id value="9cbd3dda-c51a-4e68-af70-f0de60cb8ba7"/>
    <meta>
        <versionId value="5dc8eac2-de86-4e97-949a-8eb9e26e4237"/>
        <lastUpdated value="2016-03-01T10:04:33+00:00"/>
        <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-RARecord-Condition-1" />
    </meta>
    <contained>
        <Provenance>
            <id value="8add130e-0c04-4dd1-94a0-b3317fb26dfc"/>
            <meta>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"/>
            </meta>
            <target>
                <reference value="Condition/9cbd3dda-c51a-4e68-af70-f0de60cb8ba7"/>
            </target>
            <recorded value="2016-03-01T10:05:33+00:00"/>
            <agent>
                <role>
                    <coding>
                        <system value="https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1"/>
                        <code value="R0260"/>
                        <display value="General Medical Practitioner"/>
                    </coding>
                </role>
                <whoReference>
                    <reference value="https://sds.spineservices.nhs.uk/STU3/Practitioner/2ee4tr6a9"/>
                    <display value="Dr.D"/>
                </whoReference>
                <onBehalfOfReference>
                    <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7"/>
                    <display value="Some GP Clinic"/>
                </onBehalfOfReference>
            </agent>
        </Provenance>
    </contained>
    <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1">
        <extension url="created">
            <valueReference>
                <reference value="#8add130e-0c04-4dd1-94a0-b3317fb26dfc"/>
            </valueReference>
        </extension>
    </extension>
    <clinicalStatus value="active"/>
    <category>
        <coding>
            <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-ConditionCategory-1"/>
            <code value="issue"/>
            <display value="Issue"/>
        </coding>
    </category>
    <code>
        <coding>
            <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AccessibleInformationAdjustments-1"/>
            <code value="requiresinformationineasyread"/>
            <display value="Requires information in Easyread"/>
        </coding>
    </code>
    <subject>
        <identifier>
            <reference value="demographics.spineservices.nhs.uk/STU3/Patient/999999998"/>
        </identifier>
    </subject>
</Condition>

CareConnect-RARecord-Condition-1 JSON Example

{
  "resourceType": "Condition",
  "id": "9cbd3dda-c51a-4e68-af70-f0de60cb8ba7",
  "meta": {
    "versionId": "5dc8eac2-de86-4e97-949a-8eb9e26e4237",
    "lastUpdated": "2016-03-01T10:04:33+00:00",
    "profile": [
      "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-RARecord-Condition-1"
    ]
  },
  "contained": [
    {
      "resourceType": "Provenance",
      "id": "8add130e-0c04-4dd1-94a0-b3317fb26dfc",
      "meta": {
        "profile": [
          "https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"
        ]
      },
      "target": [
        {
          "reference": "Condition/9cbd3dda-c51a-4e68-af70-f0de60cb8ba7"
        }
      ],
      "recorded": "2016-03-01T10:05:33+00:00",
      "agent": [
        {
          "role": [
            {
              "coding": [
                {
                  "system": "https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1",
                  "code": "R0260",
                  "display": "General Medical Practitioner"
                }
              ]
            }
          ],
          "whoReference": {
            "reference": "https://sds.spineservices.nhs.uk/STU3/Practitioner/2ee4tr6a9",
            "display": "Dr.D"
          },
          "onBehalfOfReference": {
            "reference": "https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7",
            "display": "Some GP Clinic"
          }
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1",
      "extension": [
        {
          "url": "created",
          "valueReference": {
            "reference": "#8add130e-0c04-4dd1-94a0-b3317fb26dfc"
          }
        }
      ]
    }
  ],
  "clinicalStatus": "active",
  "category": [
    {
      "coding": [
        {
          "system": "https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-ConditionCategory-1",
          "code": "issue",
          "display": "Issue"
        }
      ]
    }
  ],
  "code": {
    "coding": [
      {
        "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AccessibleInformationAdjustments-1",
        "code": "requiresinformationineasyread",
        "display": "Requires information in Easyread"
      }
    ]
  }
}

CareConnect-RARecord-List-1

CareConnect-RARecord-List-1 XML Example

<?xml version="1.0" encoding="utf-8"?>
<!-- CareConnect-RARecord-List-1 example -->
<List xmlns="http://hl7.org/fhir">
    <id value="56eedfcd-d883-4adb-a833-c21d4a1e0d80"/>
    <meta>
        <versionId value="145399fa-1622-4c3c-aba3-19312d5df3c3"/>
        <lastUpdated value="2016-03-01T10:04:33+00:00"/>
        <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-RARecord-List-1"/>
    </meta>
    <status value="current"/>
    <mode value="changes"/>
    <title value="Reasonable Adjustment List"/>
    <code>
        <coding>
            <system value="http://snomed.info/sct"/>
            <code value="1094391000000102"/>
            <display value="Reasonable adjustments for health and care access"/>
        </coding>
    </code>
    <subject>
        <identifier>
            <reference value="demographics.spineservices.nhs.uk/STU3/Patient/999999998"/>
        </identifier>
    </subject>
    <date value="2016-03-01T10:08:00+00:00"/>
    <entry>
        <deleted value="false"/>
        <date value="2016-03-01T10:09:00+00:00"/>
        <item>
            <!-- reference to a successfully written Condition available at referred endpoint.  -->
            <reference value="https://clinicals.spineservices.nhs.uk/STU3/Condition/9cbd3dda-c51a-4e68-af70-f0de60cb8ba7"/>
        </item>
    </entry>
    <entry>
        <deleted value="false"/>
        <date value="2016-03-01T10:09:00+00:00"/>
        <item>
            <reference value="https://clinicals.spineservices.nhs.uk/STU3/Condition/6c959805-7af1-445d-9d3e-087e3c2bc107"/>
        </item>
    </entry>
</List>

CareConnect-RARecord-List-1 JSON Example

{
  "resourceType": "List",
  "id": "56eedfcd-d883-4adb-a833-c21d4a1e0d80",
  "fhir_comments": [
    " CareConnect-RARecord-List-1 example "
  ],
  "meta": {
    "versionId": "145399fa-1622-4c3c-aba3-19312d5df3c3",
    "lastUpdated": "2016-03-01T10:04:33+00:00",
    "profile": [
      "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-RARecord-List-1"
    ]
  },
  "status": "current",
  "mode": "changes",
  "title": "Reasonable Adjustment List",
  "code": {
    "coding": [
      {
        "system": "http://snomed.info/sct",
        "code": "1094391000000102",
        "display": "Reasonable adjustments for health and care access"
      }
    ]
  },
  "date": "2016-03-01T10:08:00+00:00",
  "entry": [
    {
      "deleted": false,
      "date": "2016-03-01T10:09:00+00:00",
      "item": {
        "reference": "https://clinicals.spineservices.nhs.uk/STU3/Condition/9cbd3dda-c51a-4e68-af70-f0de60cb8ba7",
        "_reference": {
          "fhir_comments": [
            " reference to a successfully written Condition available at referred endpoint.  "
          ]
        }
      }
    },
    {
      "deleted": false,
      "date": "2016-03-01T10:09:00+00:00",
      "item": {
        "reference": "https://clinicals.spineservices.nhs.uk/STU3/Condition/6c959805-7af1-445d-9d3e-087e3c2bc107"
      }
    }
  ]
}

RARecord-Provenance-1

Provenance is a contained resource in the Flag, Condition, Consent resources (and shows in the Contained section of the examples above).

Design note:

Practitioner, Organisation and Role information can be identified by Referencing and can be accomplished within contained Provenance resources alone:

Provenance

  • target - reference, points to containing resources
  • recorded - instant, time of create update
  • agent
    • role - codeableConcept - currently this is bound to SecurityRoleType (Extensible) in base, assume needs to use/include(only) CodeSystem-CareConnect-SDSJobRoleName-1
    • who - reference(Practitioner)
      • reference - URI string, points to a (not currently resolvable) SDS FHIR endpoint e.g. https://~spineservices.nhs.uk/STU3/sdsserver/Practioner/[UUID]
      • display - string, holds name of practitioner
    • onBehalfOf - reference(Organization)
      • reference - URI string, points to a ODS API endpoint e.g. https://directory.spineservices.nhs.uk/STU3/Organization/[OrgCode]
      • display - string, holds name of organization

Under this model, there’s not going to be a contained Provenance resource on Create (or for an Update, no Extension.updated provenance). It’s constructed and contained server-side as part of the Create operation. Extension-RARecord-Provenance-1 Extension.created 1..1 cardinality is therefore relaxed to 0..1 will constrain differently to ensure well-formed feels like a FHIRPath expression saying: if this has a temporaryId, created is empty; if this has a permanent Id created exists.

Tags: rest fhir identification development

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