Resource type: communication

Description

An occurrence of information being transmitted; e.g. an alert that was sent to a responsible provider, a public health agency was notified about a reportable condition.

Elements

PathShortDefinitionComments
A record of information transmitted from a sender to a receiverAn occurrence of information being transmitted; e.g. an alert that was sent to a responsible provider, a public health agency was notified about a reportable condition.
identifierUnique identifierBusiness identifiers assigned to this communication by the performer or other systems which remain constant as the resource is updated and propagates from server to server.This is a business identifier, not a resource identifier (see [discussion](resource.html#identifiers)). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.
instantiatesCanonicalInstantiates FHIR protocol or definitionThe URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication.
instantiatesUriInstantiates external protocol or definitionThe URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication.This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
basedOnRequest fulfilled by this communicationAn order, proposal or plan fulfilled in whole or in part by this Communication.This must point to some sort of a 'Request' resource, such as CarePlan, CommunicationRequest, ServiceRequest, MedicationRequest, etc.
partOfPart of this actionPart of this action.
inResponseToReply toPrior communication that this communication is in response to.
statuspreparation | in-progress | not-done | suspended | aborted | completed | entered-in-errorThe status of the transmission.This element is labeled as a modifier because the status contains the codes aborted and entered-in-error that mark the communication as not currently valid.
statusReasonReason for current statusCaptures the reason for the current state of the Communication.This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here.
categoryMessage categoryThe type of message conveyed such as alert, notification, reminder, instruction, etc.There may be multiple axes of categorization and one communication may serve multiple purposes.
priorityMessage urgencyCharacterizes how quickly the planned or in progress communication must be addressed. Includes concepts such as stat, urgent, routine.Used to prioritize workflow (such as which communication to read first) when the communication is planned or in progress.
mediumA channel of communicationA channel that was used for this communication (e.g. email, fax).
subjectFocus of messageThe patient or group that was the focus of this communication.
topicDescription of the purpose/contentDescription of the purpose/content, similar to a subject line in an email.Communication.topic.text can be used without any codings.
aboutResources that pertain to this communicationOther resources that pertain to this communication and to which this communication should be associated.Don't use Communication.about element when a more specific element exists, such as basedOn or reasonReference.
encounterEncounter created as part ofThe Encounter during which this Communication was created or to which the creation of this record is tightly associated.This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.
sentWhen sentThe time when this communication was sent.
receivedWhen receivedThe time when this communication arrived at the destination.
recipientMessage recipientThe entity (e.g. person, organization, clinical information system, care team or device) which was the target of the communication. If receipts need to be tracked by individual, a separate resource instance will need to be created for each recipient. Multiple recipient communications are intended where either a receipt(s) is not tracked (e.g. a mass mail-out) or is captured in aggregate (all emails confirmed received by a particular time).
senderMessage senderThe entity (e.g. person, organization, clinical information system, or device) which was the source of the communication.
reasonCodeIndication for messageThe reason or justification for the communication.Textual reasons can be captured using reasonCode.text.
reasonReferenceWhy was communication done?Indicates another resource whose existence justifies this communication.
payloadMessage payloadText, attachment(s), or resource(s) that was communicated to the recipient.
payload.idUnique id for inter-element referencingUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
payload.extensionAdditional content defined by implementationsMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.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.
payload.modifierExtensionExtensions that cannot be ignored even if unrecognizedMay 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).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.
payload.content[x]Message part contentA communicated content (or for multi-part communications, one portion of the communication).
noteComments made about the communicationAdditional notes or commentary about the communication by the sender, receiver or other interested parties.

Scope and Usage

Communication is one of the event resources in the FHIR workflow specification.

This resource is a record of a communication even if it is planned or has failed. A communication is a conveyance of information from one entity, a sender, to another entity, a receiver. The sender and receivers may be patients, practitioners, related persons, organizations, or devices. Communication use cases include:

Non-patient specific communication use cases may include:

Boundaries and Relationships

This resource is a record of a communication that has occurred. It does not represent the actual flow of communication. While AuditEvent can track electronic disclosures of information, it cannot track conversations, phone calls, letters and other interactions that are not system-to-system. And even for system-to-system communications, the specific end recipients might not be known. As well, AuditEvents are not considered to be "part" of the patient record, while Communication instances are. The Communication resource is not used as a general audit mechanism to track every disclosure of every record. Rather, it is used when a clinician or other user wants to ensure a record of a particular communication is itself maintained as part of the reviewable health record.

Flag resources represent a continuous ongoing "communication" alerting anyone dealing with the patient of certain precautions to take or issues to be aware of. The flags are continuously present as an ongoing reminder. This is distinct from Communication where there is a specific intended sender and receiver and the information is delivered only once.

Communication and Encounter

The Communication is about the transfer of information (which might or might not occur as part of an encounter), while Encounter is about the coming together (in person or virtually) of a Patient with a Practitioner. Communication does not deal with the duration of a call, it represents the fact that information was transferred at a particular point in time.

The phone calls involving the Patient should be handled using Encounter. Phone calls not involving the patient (e.g. between practitioners or practitioner to relative) that are tracked for billing or other purposes can use Communication to represent the information transferred but are not ideal to represent the call itself. A better mechanism for handling such calls will be explored in a future release.

Notes to reviewers:

At this time, the code bindings are placeholders to be fleshed out upon further review by the community.

Communication.sender and Communication.recipient

Communication.sender allows Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService and Communication.recipient allows Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService - but it is not unusual to have a communication target - even a defined one - where it is unknown what kind of role the person is playing.

If the communication is to or from an individual, whose role is not known (practitioner, patient or related person), - for example, only email address is captured in the system; then RelatedPerson should be used by default.

Search Parameters

based-onRequest fulfilled by this communicationCommunication.basedOn
categoryMessage categoryCommunication.category
encounterEncounter created as part ofCommunication.encounter
identifierUnique identifierCommunication.identifier
instantiates-canonicalInstantiates FHIR protocol or definitionCommunication.instantiatesCanonical
instantiates-uriInstantiates external protocol or definitionCommunication.instantiatesUri
mediumA channel of communicationCommunication.medium
part-ofPart of this actionCommunication.partOf
patientFocus of messageCommunication.subject.where(resolve() is Patient)
receivedWhen receivedCommunication.received
recipientMessage recipientCommunication.recipient
senderMessage senderCommunication.sender
sentWhen sentCommunication.sent
statuspreparation | in-progress | not-done | suspended | aborted | completed | entered-in-errorCommunication.status
subjectFocus of messageCommunication.subject

Extension Definitions

These are extension definitions for this resource defined by the spec