QI-Core Implementation Guide
7.0.0 - STU 7 United States of America flag

This page is part of the Quality Improvement Core Framework (v7.0.0: STU7 (v7.0.0)) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: QICore Practitioner

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner Version: 7.0.0
Standards status: Trial-use Maturity Level: 4 Computable Name: QICorePractitioner

Profile of Practitioner for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

"Must Have", "QI Elements" and "primary code path" are defined in the QI-Core Must Support section.
Must Have:
  • name: The name(s) associated with the practitioner
  • identifier: (QI) An identifier for the person as this agent
QI Elements:
  • identifier.use: (QI) usual | official | temp | secondary | old (If known)
  • identifier(NPI): (QI) An identifier for the person as this agent
  • identifier.value: (QI) The value that is unique
  • identifier(ein): (QI) There is not a general Tax Identifier Numer (TIN) OID. There is an SSN, a PTIN, and an ITIN, but no TIN generally. So the only slice specified here is EIN, if consumers determine a need for an SSN, submit a comment to that effect.
  • identifier.system: (QI) The namespace for the identifier value
Usage

See the patterns page for implementation and usage patterns.

Examples

Referring Practitioner Example

Usages:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Practitioner 0..* USCorePractitionerProfile A person with a formal responsibility in the provisioning of healthcare or related services
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 1..* Identifier (QI) An identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:All Slices Content/Rules for all slices
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... system SΣ 1..1 uri (QI) The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 1..1 string (QI) The value that is unique
Example General: 123456
.... identifier:NPI SΣC 0..* Identifier (QI) An identifier for the person as this agent
Constraints: us-core-16, us-core-17

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... use 0..1 code usual | official | temp | secondary | old (If known)
..... type 0..1 CodeableConcept Description of identifier
..... system 1..1 uri The namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... value 0..1 string The value that is unique
..... period 0..1 Period Time period when id is/was valid for use
..... assigner 0..1 Reference(Organization) Organization that issued id (may be just text)
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... system Σ 1..1 uri (QI) The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ 1..1 string (QI) The value that is unique
Example General: 123456
.... identifier:ein SΣ 0..1 Identifier (QI) There is not a general Tax Identifier Numer (TIN) OID. There is an SSN, a PTIN, and an ITIN, but no TIN generally. So the only slice specified here is EIN, if consumers determine a need for an SSN, submit a comment to that effect.

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... use 0..1 code usual | official | temp | secondary | old (If known)
..... type 0..1 CodeableConcept Description of identifier
..... system 1..1 uri The namespace for the identifier value
Fixed Value: urn:oid:2.16.840.1.113883.4.4
..... value 0..1 string The value that is unique
..... period 0..1 Period Time period when id is/was valid for use
..... assigner 0..1 Reference(Organization) Organization that issued id (may be just text)
..... use ?!Σ 1..1 code (QI) usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... system Σ 1..1 uri (QI) The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ 1..1 string (QI) The value that is unique
Example General: 123456
.... use ?!Σ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.
.... family SΣ 1..1 string Family name (often called 'Surname')
... telecom SΣ 0..* ContactPoint A contact detail for the practitioner (that apply to all roles)
.... system SΣC 0..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.
.... value SΣ 0..1 string The actual contact point details
.... use ?!Σ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point.
... address SΣ 0..* Address Address(es) of the practitioner
.... use ?!Σ 0..1 code home | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.
Example General: home
.... line SΣ 0..4 string Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
Example General: 49 MEADOW ST
.... city SΣ 0..1 string Name of city, town etc.
Example General: Erewhon
Example General: EVERYTOWN
.... state SΣ 0..1 string Sub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.
Example General: OK
.... postalCode SΣ 0..1 string US Zip Codes
Example General: 9132
Example General: 74047
.... country SΣ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Practitioner.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
From the FHIR Standard
Practitioner.identifier:NPI.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
From the FHIR Standard
Practitioner.identifier:ein.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
From the FHIR Standard
Practitioner.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
From the FHIR Standard
Practitioner.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
From the FHIR Standard
Practitioner.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
From the FHIR Standard
Practitioner.address.userequiredAddressUse
http://hl7.org/fhir/ValueSet/address-use|4.0.1
From the FHIR Standard
Practitioner.address.stateextensibleUspsTwoLetterAlphabeticCodes(a valid code from https://www.usps.com/)
http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorPractitionerIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorPractitionerIf 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-4errorPractitionerIf 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-5errorPractitionerIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practicePractitionerA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
us-core-16errorPractitioner.identifier:NPINPI must be 10 digits
: value.matches('^[0-9]{10}$')
us-core-17errorPractitioner.identifier:NPINPI check digit must be valid (Luhn algorithm check)
: (((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger()) + 24)mod 10=0)

This structure is derived from USCorePractitionerProfile

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Practitioner USCorePractitionerProfile
... Slices for identifier 1..* Identifier (QI) An identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:All Slices Content/Rules for all slices
..... system 1..1 uri (QI) The namespace for the identifier value
..... value 1..1 string (QI) The value that is unique
.... identifier:NPI C 0..* Identifier (QI) An identifier for the person as this agent
Required Pattern: At least the following
..... system 1..1 uri The namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
.... identifier:ein 0..1 Identifier (QI) There is not a general Tax Identifier Numer (TIN) OID. There is an SSN, a PTIN, and an ITIN, but no TIN generally. So the only slice specified here is EIN, if consumers determine a need for an SSN, submit a comment to that effect.
Required Pattern: At least the following
..... system 1..1 uri The namespace for the identifier value
Fixed Value: urn:oid:2.16.840.1.113883.4.4
..... use 1..1 code (QI) usual | official | temp | secondary | old (If known)
..... value 1..1 string (QI) The value that is unique

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Practitioner 0..* USCorePractitionerProfile A person with a formal responsibility in the provisioning of healthcare or related services
... 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
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 1..* Identifier (QI) An identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
..... system SΣ 1..1 uri (QI) The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 1..1 string (QI) The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:NPI SΣC 0..* Identifier (QI) An identifier for the person as this agent
Constraints: us-core-16, us-core-17

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... use 0..1 code usual | official | temp | secondary | old (If known)
..... type 0..1 CodeableConcept Description of identifier
..... system 1..1 uri The namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... value 0..1 string The value that is unique
..... period 0..1 Period Time period when id is/was valid for use
..... assigner 0..1 Reference(Organization) Organization that issued id (may be just text)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
..... system Σ 1..1 uri (QI) The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ 1..1 string (QI) The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:ein SΣ 0..1 Identifier (QI) There is not a general Tax Identifier Numer (TIN) OID. There is an SSN, a PTIN, and an ITIN, but no TIN generally. So the only slice specified here is EIN, if consumers determine a need for an SSN, submit a comment to that effect.

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... use 0..1 code usual | official | temp | secondary | old (If known)
..... type 0..1 CodeableConcept Description of identifier
..... system 1..1 uri The namespace for the identifier value
Fixed Value: urn:oid:2.16.840.1.113883.4.4
..... value 0..1 string The value that is unique
..... period 0..1 Period Time period when id is/was valid for use
..... assigner 0..1 Reference(Organization) Organization that issued id (may be just text)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 1..1 code (QI) usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
..... system Σ 1..1 uri (QI) The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ 1..1 string (QI) The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... active Σ 0..1 boolean Whether this practitioner's record is in active use
... name SΣ 1..* HumanName The name(s) associated with the practitioner
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.
.... text Σ 0..1 string Text representation of the full name
.... family SΣ 1..1 string Family name (often called 'Surname')
.... given Σ 0..* string Given names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
.... prefix Σ 0..* string Parts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
.... suffix Σ 0..* string Parts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
.... period Σ 0..1 Period Time period when name was/is in use
... telecom SΣ 0..* ContactPoint A contact detail for the practitioner (that apply to all roles)
.... 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 SΣC 0..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.
.... value SΣ 0..1 string The actual contact point details
.... use ?!Σ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point.
.... rank Σ 0..1 positiveInt Specify preferred order of use (1 = highest)
.... period Σ 0..1 Period Time period when the contact point was/is in use
... address SΣ 0..* Address Address(es) of the practitioner
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code home | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.
Example General: home
.... type Σ 0..1 code postal | physical | both
Binding: AddressType (required): The type of an address (physical / postal).
Example General: both
.... text Σ 0..1 string Text representation of the address
Example General: 137 Nowhere Street, Erewhon 9132
.... line SΣ 0..4 string Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
Example General: 49 MEADOW ST
.... city SΣ 0..1 string Name of city, town etc.
Example General: Erewhon
Example General: EVERYTOWN
.... district Σ 0..1 string District name (aka county)
Example General: Madison
.... state SΣ 0..1 string Sub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.
Example General: OK
.... postalCode SΣ 0..1 string US Zip Codes
Example General: 9132
Example General: 74047
.... country SΣ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)
.... period Σ 0..1 Period Time period when address was/is in use
Example General: {"start":"2010-03-23","end":"2010-07-01"}
... gender Σ 0..1 code male | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
... birthDate Σ 0..1 date The date on which the practitioner was born
... photo 0..* Attachment Image of the person
... qualification 0..* BackboneElement Certification, licenses, or training pertaining to the provision of care
.... 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
.... identifier 0..* Identifier An identifier for this qualification for the practitioner
.... code 1..1 CodeableConcept Coded representation of the qualification
Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.
.... period 0..1 Period Period during which the qualification is valid
.... issuer 0..1 Reference(Organization) Organization that regulates and issues the qualification
... communication 0..* CodeableConcept A language the practitioner can use in patient communication
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Practitioner.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
From the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Practitioner.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
From the FHIR Standard
Practitioner.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
From the FHIR Standard
Practitioner.identifier:NPI.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
From the FHIR Standard
Practitioner.identifier:NPI.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
From the FHIR Standard
Practitioner.identifier:ein.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
From the FHIR Standard
Practitioner.identifier:ein.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
From the FHIR Standard
Practitioner.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
From the FHIR Standard
Practitioner.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
From the FHIR Standard
Practitioner.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
From the FHIR Standard
Practitioner.address.userequiredAddressUse
http://hl7.org/fhir/ValueSet/address-use|4.0.1
From the FHIR Standard
Practitioner.address.typerequiredAddressType
http://hl7.org/fhir/ValueSet/address-type|4.0.1
From the FHIR Standard
Practitioner.address.stateextensibleUspsTwoLetterAlphabeticCodes(a valid code from https://www.usps.com/)
http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state
Practitioner.genderrequiredAdministrativeGender
http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
From the FHIR Standard
Practitioner.qualification.codeexamplev2.0360.2.7(a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7)
http://terminology.hl7.org/ValueSet/v2-2.7-0360
From the FHIR Standard
Practitioner.communicationpreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
From the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorPractitionerIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorPractitionerIf 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-4errorPractitionerIf 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-5errorPractitionerIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practicePractitionerA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
us-core-16errorPractitioner.identifier:NPINPI must be 10 digits
: value.matches('^[0-9]{10}$')
us-core-17errorPractitioner.identifier:NPINPI check digit must be valid (Luhn algorithm check)
: (((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger()) + 24)mod 10=0)

This structure is derived from USCorePractitionerProfile

Summary

Mandatory: 1 element(4 nested mandatory elements)

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Practitioner.identifier

Maturity: 4

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Practitioner 0..* USCorePractitionerProfile A person with a formal responsibility in the provisioning of healthcare or related services
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 1..* Identifier (QI) An identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:All Slices Content/Rules for all slices
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... system SΣ 1..1 uri (QI) The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 1..1 string (QI) The value that is unique
Example General: 123456
.... identifier:NPI SΣC 0..* Identifier (QI) An identifier for the person as this agent
Constraints: us-core-16, us-core-17

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... use 0..1 code usual | official | temp | secondary | old (If known)
..... type 0..1 CodeableConcept Description of identifier
..... system 1..1 uri The namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... value 0..1 string The value that is unique
..... period 0..1 Period Time period when id is/was valid for use
..... assigner 0..1 Reference(Organization) Organization that issued id (may be just text)
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... system Σ 1..1 uri (QI) The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ 1..1 string (QI) The value that is unique
Example General: 123456
.... identifier:ein SΣ 0..1 Identifier (QI) There is not a general Tax Identifier Numer (TIN) OID. There is an SSN, a PTIN, and an ITIN, but no TIN generally. So the only slice specified here is EIN, if consumers determine a need for an SSN, submit a comment to that effect.

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... use 0..1 code usual | official | temp | secondary | old (If known)
..... type 0..1 CodeableConcept Description of identifier
..... system 1..1 uri The namespace for the identifier value
Fixed Value: urn:oid:2.16.840.1.113883.4.4
..... value 0..1 string The value that is unique
..... period 0..1 Period Time period when id is/was valid for use
..... assigner 0..1 Reference(Organization) Organization that issued id (may be just text)
..... use ?!Σ 1..1 code (QI) usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... system Σ 1..1 uri (QI) The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ 1..1 string (QI) The value that is unique
Example General: 123456
.... use ?!Σ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.
.... family SΣ 1..1 string Family name (often called 'Surname')
... telecom SΣ 0..* ContactPoint A contact detail for the practitioner (that apply to all roles)
.... system SΣC 0..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.
.... value SΣ 0..1 string The actual contact point details
.... use ?!Σ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point.
... address SΣ 0..* Address Address(es) of the practitioner
.... use ?!Σ 0..1 code home | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.
Example General: home
.... line SΣ 0..4 string Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
Example General: 49 MEADOW ST
.... city SΣ 0..1 string Name of city, town etc.
Example General: Erewhon
Example General: EVERYTOWN
.... state SΣ 0..1 string Sub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.
Example General: OK
.... postalCode SΣ 0..1 string US Zip Codes
Example General: 9132
Example General: 74047
.... country SΣ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Practitioner.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
From the FHIR Standard
Practitioner.identifier:NPI.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
From the FHIR Standard
Practitioner.identifier:ein.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
From the FHIR Standard
Practitioner.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
From the FHIR Standard
Practitioner.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
From the FHIR Standard
Practitioner.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
From the FHIR Standard
Practitioner.address.userequiredAddressUse
http://hl7.org/fhir/ValueSet/address-use|4.0.1
From the FHIR Standard
Practitioner.address.stateextensibleUspsTwoLetterAlphabeticCodes(a valid code from https://www.usps.com/)
http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorPractitionerIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorPractitionerIf 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-4errorPractitionerIf 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-5errorPractitionerIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practicePractitionerA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
us-core-16errorPractitioner.identifier:NPINPI must be 10 digits
: value.matches('^[0-9]{10}$')
us-core-17errorPractitioner.identifier:NPINPI check digit must be valid (Luhn algorithm check)
: (((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger()) + 24)mod 10=0)

Differential View

This structure is derived from USCorePractitionerProfile

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Practitioner USCorePractitionerProfile
... Slices for identifier 1..* Identifier (QI) An identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:All Slices Content/Rules for all slices
..... system 1..1 uri (QI) The namespace for the identifier value
..... value 1..1 string (QI) The value that is unique
.... identifier:NPI C 0..* Identifier (QI) An identifier for the person as this agent
Required Pattern: At least the following
..... system 1..1 uri The namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
.... identifier:ein 0..1 Identifier (QI) There is not a general Tax Identifier Numer (TIN) OID. There is an SSN, a PTIN, and an ITIN, but no TIN generally. So the only slice specified here is EIN, if consumers determine a need for an SSN, submit a comment to that effect.
Required Pattern: At least the following
..... system 1..1 uri The namespace for the identifier value
Fixed Value: urn:oid:2.16.840.1.113883.4.4
..... use 1..1 code (QI) usual | official | temp | secondary | old (If known)
..... value 1..1 string (QI) The value that is unique

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Practitioner 0..* USCorePractitionerProfile A person with a formal responsibility in the provisioning of healthcare or related services
... 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
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 1..* Identifier (QI) An identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
..... system SΣ 1..1 uri (QI) The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 1..1 string (QI) The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:NPI SΣC 0..* Identifier (QI) An identifier for the person as this agent
Constraints: us-core-16, us-core-17

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... use 0..1 code usual | official | temp | secondary | old (If known)
..... type 0..1 CodeableConcept Description of identifier
..... system 1..1 uri The namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... value 0..1 string The value that is unique
..... period 0..1 Period Time period when id is/was valid for use
..... assigner 0..1 Reference(Organization) Organization that issued id (may be just text)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
..... system Σ 1..1 uri (QI) The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ 1..1 string (QI) The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:ein SΣ 0..1 Identifier (QI) There is not a general Tax Identifier Numer (TIN) OID. There is an SSN, a PTIN, and an ITIN, but no TIN generally. So the only slice specified here is EIN, if consumers determine a need for an SSN, submit a comment to that effect.

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... use 0..1 code usual | official | temp | secondary | old (If known)
..... type 0..1 CodeableConcept Description of identifier
..... system 1..1 uri The namespace for the identifier value
Fixed Value: urn:oid:2.16.840.1.113883.4.4
..... value 0..1 string The value that is unique
..... period 0..1 Period Time period when id is/was valid for use
..... assigner 0..1 Reference(Organization) Organization that issued id (may be just text)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 1..1 code (QI) usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
..... system Σ 1..1 uri (QI) The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ 1..1 string (QI) The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... active Σ 0..1 boolean Whether this practitioner's record is in active use
... name SΣ 1..* HumanName The name(s) associated with the practitioner
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.
.... text Σ 0..1 string Text representation of the full name
.... family SΣ 1..1 string Family name (often called 'Surname')
.... given Σ 0..* string Given names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
.... prefix Σ 0..* string Parts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
.... suffix Σ 0..* string Parts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
.... period Σ 0..1 Period Time period when name was/is in use
... telecom SΣ 0..* ContactPoint A contact detail for the practitioner (that apply to all roles)
.... 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 SΣC 0..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.
.... value SΣ 0..1 string The actual contact point details
.... use ?!Σ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point.
.... rank Σ 0..1 positiveInt Specify preferred order of use (1 = highest)
.... period Σ 0..1 Period Time period when the contact point was/is in use
... address SΣ 0..* Address Address(es) of the practitioner
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code home | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.
Example General: home
.... type Σ 0..1 code postal | physical | both
Binding: AddressType (required): The type of an address (physical / postal).
Example General: both
.... text Σ 0..1 string Text representation of the address
Example General: 137 Nowhere Street, Erewhon 9132
.... line SΣ 0..4 string Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
Example General: 49 MEADOW ST
.... city SΣ 0..1 string Name of city, town etc.
Example General: Erewhon
Example General: EVERYTOWN
.... district Σ 0..1 string District name (aka county)
Example General: Madison
.... state SΣ 0..1 string Sub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.
Example General: OK
.... postalCode SΣ 0..1 string US Zip Codes
Example General: 9132
Example General: 74047
.... country SΣ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)
.... period Σ 0..1 Period Time period when address was/is in use
Example General: {"start":"2010-03-23","end":"2010-07-01"}
... gender Σ 0..1 code male | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
... birthDate Σ 0..1 date The date on which the practitioner was born
... photo 0..* Attachment Image of the person
... qualification 0..* BackboneElement Certification, licenses, or training pertaining to the provision of care
.... 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
.... identifier 0..* Identifier An identifier for this qualification for the practitioner
.... code 1..1 CodeableConcept Coded representation of the qualification
Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.
.... period 0..1 Period Period during which the qualification is valid
.... issuer 0..1 Reference(Organization) Organization that regulates and issues the qualification
... communication 0..* CodeableConcept A language the practitioner can use in patient communication
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Practitioner.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
From the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Practitioner.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
From the FHIR Standard
Practitioner.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
From the FHIR Standard
Practitioner.identifier:NPI.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
From the FHIR Standard
Practitioner.identifier:NPI.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
From the FHIR Standard
Practitioner.identifier:ein.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
From the FHIR Standard
Practitioner.identifier:ein.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
From the FHIR Standard
Practitioner.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
From the FHIR Standard
Practitioner.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
From the FHIR Standard
Practitioner.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
From the FHIR Standard
Practitioner.address.userequiredAddressUse
http://hl7.org/fhir/ValueSet/address-use|4.0.1
From the FHIR Standard
Practitioner.address.typerequiredAddressType
http://hl7.org/fhir/ValueSet/address-type|4.0.1
From the FHIR Standard
Practitioner.address.stateextensibleUspsTwoLetterAlphabeticCodes(a valid code from https://www.usps.com/)
http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state
Practitioner.genderrequiredAdministrativeGender
http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
From the FHIR Standard
Practitioner.qualification.codeexamplev2.0360.2.7(a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7)
http://terminology.hl7.org/ValueSet/v2-2.7-0360
From the FHIR Standard
Practitioner.communicationpreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
From the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorPractitionerIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorPractitionerIf 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-4errorPractitionerIf 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-5errorPractitionerIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practicePractitionerA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
us-core-16errorPractitioner.identifier:NPINPI must be 10 digits
: value.matches('^[0-9]{10}$')
us-core-17errorPractitioner.identifier:NPINPI check digit must be valid (Luhn algorithm check)
: (((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger()) + 24)mod 10=0)

This structure is derived from USCorePractitionerProfile

Summary

Mandatory: 1 element(4 nested mandatory elements)

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Practitioner.identifier

Maturity: 4

 

Other representations of profile: CSV, Excel, Schematron