A formally or informally recognized grouping of people or organizations formed for the purpose of achieving some form of collective action. Includes companies, institutions, corporations, departments, community groups, healthcare practice groups, payer/insurer, etc.

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.

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.

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).

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.

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.

Identifier for the organization that is used to identify the organization across multiple disparate systems.

Motivation Kardinalität und Must Support: Jede Organisation muss über einen Business Identifier eindeutig identifiziert werden können.

Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization.

Identifier for the organization that is used to identify the organization across multiple disparate systems.

Motivation: Entsprechend der Vorgabe der KBV Organisation 1.5.0. (https://fhir.kbv.de/StructureDefinition/KBV_PR_Base_Organization), muss ein System ein Institutionskennzeichen (IKNR) verarbeiten können, sofern diese Information verfügbar ist.

Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization.

Identifier for the organization that is used to identify the organization across multiple disparate systems.

Motivation: Entsprechend der Bedarfsmeldung im Rahmen der Stakeholderbefragung zu einem Profil Organisation in der Arbeitsgruppe zum ISIK Basismodul Stufe 4 und der Vorgabe der KBV Organisation 1.5.0. (https://fhir.kbv.de/StructureDefinition/KBV_PR_Base_Organization), muss ein System eine Betriebsstättennummer (BSNR) verarbeiten können, sofern diese Information verfügbar ist.

Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization.

Identifier for the organization that is used to identify the organization across multiple disparate systems.

Hinweis: Für IDs, die krankenhaus-intern spezifischen Organisationseinheiten wie Abteilungen oder Stationen vergeben werden, ist diese Identifier zu nutzen - analog zu Slice Abteilungsidentifikator in https://simplifier.net/medizininformatikinitiative-modulstrukturdaten/mii_pr_struktur_abteilung. Da auch Stationen im Identifier-System inkludiert werden könnten, sollte hier das Identifier generisch Organisationseinheiten abbilden und nicht Abteilungen allein.

Motivation Must Support: Jede Organisation, die über eine Organisationseinheiten-ID verfügt, soll dadurch eindeutig identifiziert werden können.

Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization.

The purpose of this identifier.

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Identifies the purpose for this identifier, if known .

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Identifier.system is always case sensitive.

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Identifier for the organization that is used to identify the organization across multiple disparate systems.

Motivation Must Support: Jede Organisation, die über eine Telematik-ID verfügt, soll dadurch eindeutig identifiziert werden können.

Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization.

Whether the organization's record is still in active use.

Motivation: Ein System muss prüfen können, ob eine Organisation aktiv ist oder nicht, sofern diese Information verfügbar ist.

Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI.

The kind(s) of organization that this is.

Motivation: Ein System muss den Typ einer Organisation zum Abruf bereitstellen, sofern diese Information verfügbar ist. Die Festlegung einer endlichen Menge von Organisations-Formen in verbindlicher weise, ist zum Zeitpunkt der Festlegung nicht möglich.

Used to categorize the organization.

Need to be able to track the kind of organization that this is - different organization types have different uses.

The kind(s) of organization that this is.

Definiert den allgemeinen Typ der Organisation.

Need to be able to track the kind of organization that this is - different organization types have different uses.

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

The identification of the code system that defines the meaning of the symbol in the code.

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Need to refer to a particular code in the system.

The kind(s) of organization that this is.

Beschreibt die Art der Einrichtung nach IHE XDS Standards.

Need to be able to track the kind of organization that this is - different organization types have different uses.

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

The identification of the code system that defines the meaning of the symbol in the code.

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Need to refer to a particular code in the system.

The kind(s) of organization that this is.

Spezifiziert den erweiterten Fachabteilungsschlüssel für medizinische Einrichtungen.

Need to be able to track the kind of organization that this is - different organization types have different uses.

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

The identification of the code system that defines the meaning of the symbol in the code.

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Need to refer to a particular code in the system.

A name associated with the organization.

Motivation: Ein System muss den Namen einer Organisation zum Abruf bereitstellen, sofern diese Information verfügbar ist. Begründung Pflichtfeld: Da der Name sowohl im Kontext des EHDS als auch im Rahmen der ePA als verpflichtendes Element definiert ist, wird er in ISiK aus Gründen der Kompatibilität ebenfalls als Pflichtfeld festgelegt.

Need to use the name as the label of the organization.

A list of alternate names that the organization is known as, or was known as in the past.

Hinweis: unter Umstaänden können hier Kürzel genutzt werden. Motivation: Ein System muss den Alias einer Organisation zum Abruf bereitstellen, sofern diese Information verfügbar ist.

Over time locations and organizations go through many changes and can be known by different names.

For searching knowing previous names that the organization was known by can be very useful.

A contact detail for the organization.

Motivation: Ein System muss Kontaktinformation einer Organisation zum Abruf bereitstellen, sofern diese Information verfügbar ist.

Human contact for the organization.

An address for the organization.

Um zwischen Postfachadressen und physischen Adressen, Straßennamen und Hausnummern zu unterscheiden und Städtenamenszusätze hinzuzufügen, können Anbieter die Erweiterungen unterstützen, die im Deutschen Adress-Basisprofil vorgeschlagen werden (http://fhir.de/StructureDefinition/address-de-basis). Solche Differenzierungen sind jedoch im Rahmen dieser Spezifikation nicht erforderlich.

May need to keep track of the organization's addresses for contacting, billing or reporting requirements.

An address for the organization.

Wohn- oder Aufenthaltsort des Patienten

May need to keep track of the organization's addresses for contacting, billing or reporting requirements.

A subsection of a municipality.

The purpose of this address.

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

The use of an address.

Allows an appropriate address to be chosen from a list of many.

Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

The type of an address (physical / postal).

Diese Komponente kann Straßennamen, Hausnummer, Appartmentnummer, Postfach, c/o sowie weitere Zustellungshinweise enthalten. Die Informationen können in mehrere line-Komponenten aufgeteilt werden. Bei Verwendung der Extensions, um Straße, Hausnnummer und Postleitzahl strukturiert zu übermitteln, müssen diese Informationen stets vollständig auch in der line-Komponente, die sie erweitern, enthalten sein, um es Systemen, die diese Extensions nicht verwenden zu ermöglichen, auf diese Informationen zugreifen zu können.

Note that FHIR strings SHALL NOT exceed 1MB in size

streetName.

The number of a building, house or lot alongside the street. Also known as "primary street number". This does not number the street but rather the building.

This can be a unit designator, such as apartment number, suite number, or floor. There may be several unit designators in an address (e.g., "3rd floor, Appt. 342"). This can also be a designator pointing away from the location, rather than specifying a smaller location within some larger one (e.g., Dutch "t.o." means "opposite to" for house boats located across the street facing houses).

A numbered box located in a post station.

The name of the city, town, suburb, village or other community or delivery center.

Note that FHIR strings SHALL NOT exceed 1MB in size

The name of the administrative area (county).

District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

Postleitzahl gemäß der im jeweiligen Land gültigen Konventionen

Note that FHIR strings SHALL NOT exceed 1MB in size

Staatsangabe (ohne festgeschriebenen Wertevorrat)

ISO 3166 3 letter codes can be used in place of a human readable country name.

Kodierte Angabe des Länderkennzeichens nach ISO 3166-1.

Diese Abbildung entspricht der auf EU-Ebene in Abstimmung befindlichen Profilierung zur Kodierung der Landesangabe. Durch die Verwendung der internationalen Kodierung wird die interoperable Verwendung der Adressangabe erleichtert.

May 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.

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

A coded representation for a string. Could be codes for country in a country address part, codes for prefixes in a name part, etc.

An address for the organization.

Adresse, die nur für postalische Zustellung genutzt werden kann.

May need to keep track of the organization's addresses for contacting, billing or reporting requirements.

A subsection of a municipality.

The purpose of this address.

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

The use of an address.

Allows an appropriate address to be chosen from a list of many.

Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

The type of an address (physical / postal).

Diese Komponente kann Straßennamen, Hausnummer, Appartmentnummer, Postfach, c/o sowie weitere Zustellungshinweise enthalten. Die Informationen können in mehrere line-Komponenten aufgeteilt werden. Bei Verwendung der Extensions, um Straße, Hausnnummer und Postleitzahl strukturiert zu übermitteln, müssen diese Informationen stets vollständig auch in der line-Komponente, die sie erweitern, enthalten sein, um es Systemen, die diese Extensions nicht verwenden zu ermöglichen, auf diese Informationen zugreifen zu können.

Note that FHIR strings SHALL NOT exceed 1MB in size

streetName.

The number of a building, house or lot alongside the street. Also known as "primary street number". This does not number the street but rather the building.

This can be a unit designator, such as apartment number, suite number, or floor. There may be several unit designators in an address (e.g., "3rd floor, Appt. 342"). This can also be a designator pointing away from the location, rather than specifying a smaller location within some larger one (e.g., Dutch "t.o." means "opposite to" for house boats located across the street facing houses).

A numbered box located in a post station.

The name of the city, town, suburb, village or other community or delivery center.

Note that FHIR strings SHALL NOT exceed 1MB in size

The name of the administrative area (county).

District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

Postleitzahl gemäß der im jeweiligen Land gültigen Konventionen

Note that FHIR strings SHALL NOT exceed 1MB in size

Staatsangabe (ohne festgeschriebenen Wertevorrat)

ISO 3166 3 letter codes can be used in place of a human readable country name.

Kodierte Angabe des Länderkennzeichens nach ISO 3166-1.

Diese Abbildung entspricht der auf EU-Ebene in Abstimmung befindlichen Profilierung zur Kodierung der Landesangabe. Durch die Verwendung der internationalen Kodierung wird die interoperable Verwendung der Adressangabe erleichtert.

May 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.

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

A coded representation for a string. Could be codes for country in a country address part, codes for prefixes in a name part, etc.

The organization of which this organization forms a part.

Motivation: System muss die Hierarchie einer Organisationseinheit innherhalb einer Organisation zum Abruf bereitstellen, sofern diese Information verfügbar ist.

Need to be able to track the hierarchy of organizations within an organization.

Contact for the organization for a certain purpose.

Motivation: Ein System muss Kontaktinformation einer Organisation zum Abruf bereitstellen, sofern diese Information verfügbar ist.

Need to keep track of assigned contact points within bigger organization.

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).

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.

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.

Technical endpoints providing access to services operated for the organization.

Motivation: Ein System muss den technischen Endpunt einer Organisation zum Abruf bereitstellen, sofern diese Information verfügbar ist.

Organizations have multiple systems that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose.

Motivation Kardinalität und Must Support: Jede Organisation muss über einen Business Identifier eindeutig identifiziert werden können.

Motivation: Entsprechend der Vorgabe der KBV Organisation 1.5.0. (https://fhir.kbv.de/StructureDefinition/KBV_PR_Base_Organization), muss ein System ein Institutionskennzeichen (IKNR) verarbeiten können, sofern diese Information verfügbar ist.

Motivation: Entsprechend der Bedarfsmeldung im Rahmen der Stakeholderbefragung zu einem Profil Organisation in der Arbeitsgruppe zum ISIK Basismodul Stufe 4 und der Vorgabe der KBV Organisation 1.5.0. (https://fhir.kbv.de/StructureDefinition/KBV_PR_Base_Organization), muss ein System eine Betriebsstättennummer (BSNR) verarbeiten können, sofern diese Information verfügbar ist.

Hinweis: Für IDs, die krankenhaus-intern spezifischen Organisationseinheiten wie Abteilungen oder Stationen vergeben werden, ist diese Identifier zu nutzen - analog zu Slice Abteilungsidentifikator in https://simplifier.net/medizininformatikinitiative-modulstrukturdaten/mii_pr_struktur_abteilung. Da auch Stationen im Identifier-System inkludiert werden könnten, sollte hier das Identifier generisch Organisationseinheiten abbilden und nicht Abteilungen allein.

Motivation Must Support: Jede Organisation, die über eine Organisationseinheiten-ID verfügt, soll dadurch eindeutig identifiziert werden können.

Motivation Must Support: Jede Organisation, die über eine Telematik-ID verfügt, soll dadurch eindeutig identifiziert werden können.

Motivation: Ein System muss prüfen können, ob eine Organisation aktiv ist oder nicht, sofern diese Information verfügbar ist.

Motivation: Ein System muss den Typ einer Organisation zum Abruf bereitstellen, sofern diese Information verfügbar ist. Die Festlegung einer endlichen Menge von Organisations-Formen in verbindlicher weise, ist zum Zeitpunkt der Festlegung nicht möglich.

Definiert den allgemeinen Typ der Organisation.

Beschreibt die Art der Einrichtung nach IHE XDS Standards.

Spezifiziert den erweiterten Fachabteilungsschlüssel für medizinische Einrichtungen.

Motivation: Ein System muss den Namen einer Organisation zum Abruf bereitstellen, sofern diese Information verfügbar ist. Begründung Pflichtfeld: Da der Name sowohl im Kontext des EHDS als auch im Rahmen der ePA als verpflichtendes Element definiert ist, wird er in ISiK aus Gründen der Kompatibilität ebenfalls als Pflichtfeld festgelegt.

Hinweis: unter Umstaänden können hier Kürzel genutzt werden. Motivation: Ein System muss den Alias einer Organisation zum Abruf bereitstellen, sofern diese Information verfügbar ist.

Motivation: Ein System muss Kontaktinformation einer Organisation zum Abruf bereitstellen, sofern diese Information verfügbar ist.

Um zwischen Postfachadressen und physischen Adressen, Straßennamen und Hausnummern zu unterscheiden und Städtenamenszusätze hinzuzufügen, können Anbieter die Erweiterungen unterstützen, die im Deutschen Adress-Basisprofil vorgeschlagen werden (http://fhir.de/StructureDefinition/address-de-basis). Solche Differenzierungen sind jedoch im Rahmen dieser Spezifikation nicht erforderlich.

Wohn- oder Aufenthaltsort des Patienten

Adresse, die nur für postalische Zustellung genutzt werden kann.

Motivation: System muss die Hierarchie einer Organisationseinheit innherhalb einer Organisation zum Abruf bereitstellen, sofern diese Information verfügbar ist.

Motivation: Ein System muss Kontaktinformation einer Organisation zum Abruf bereitstellen, sofern diese Information verfügbar ist.

Motivation: Ein System muss den technischen Endpunt einer Organisation zum Abruf bereitstellen, sofern diese Information verfügbar ist.

A formally or informally recognized grouping of people or organizations formed for the purpose of achieving some form of collective action. Includes companies, institutions, corporations, departments, community groups, healthcare practice groups, payer/insurer, etc.

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

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.

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.

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.

The base language in which the resource is written.

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).

A human language.

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.

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.

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.

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.

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.

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.

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).

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.

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.

Identifier for the organization that is used to identify the organization across multiple disparate systems.

Motivation Kardinalität und Must Support: Jede Organisation muss über einen Business Identifier eindeutig identifiziert werden können.

Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization.

Identifier for the organization that is used to identify the organization across multiple disparate systems.

Motivation: Entsprechend der Vorgabe der KBV Organisation 1.5.0. (https://fhir.kbv.de/StructureDefinition/KBV_PR_Base_Organization), muss ein System ein Institutionskennzeichen (IKNR) verarbeiten können, sofern diese Information verfügbar ist.

Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization.

Identifier for the organization that is used to identify the organization across multiple disparate systems.

Motivation: Entsprechend der Bedarfsmeldung im Rahmen der Stakeholderbefragung zu einem Profil Organisation in der Arbeitsgruppe zum ISIK Basismodul Stufe 4 und der Vorgabe der KBV Organisation 1.5.0. (https://fhir.kbv.de/StructureDefinition/KBV_PR_Base_Organization), muss ein System eine Betriebsstättennummer (BSNR) verarbeiten können, sofern diese Information verfügbar ist.

Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization.

Identifier for the organization that is used to identify the organization across multiple disparate systems.

Hinweis: Für IDs, die krankenhaus-intern spezifischen Organisationseinheiten wie Abteilungen oder Stationen vergeben werden, ist diese Identifier zu nutzen - analog zu Slice Abteilungsidentifikator in https://simplifier.net/medizininformatikinitiative-modulstrukturdaten/mii_pr_struktur_abteilung. Da auch Stationen im Identifier-System inkludiert werden könnten, sollte hier das Identifier generisch Organisationseinheiten abbilden und nicht Abteilungen allein.

Motivation Must Support: Jede Organisation, die über eine Organisationseinheiten-ID verfügt, soll dadurch eindeutig identifiziert werden können.

Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May 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.

The purpose of this identifier.

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Identifies the purpose for this identifier, if known .

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Allows users to make use of identifiers when the identifier system is not known.

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Identifier.system is always case sensitive.

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Time period during which identifier is/was valid for use.

Organization that issued/manages the identifier.

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Identifier for the organization that is used to identify the organization across multiple disparate systems.

Motivation Must Support: Jede Organisation, die über eine Telematik-ID verfügt, soll dadurch eindeutig identifiziert werden können.

Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization.

Whether the organization's record is still in active use.

Motivation: Ein System muss prüfen können, ob eine Organisation aktiv ist oder nicht, sofern diese Information verfügbar ist.

Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI.

The kind(s) of organization that this is.

Motivation: Ein System muss den Typ einer Organisation zum Abruf bereitstellen, sofern diese Information verfügbar ist. Die Festlegung einer endlichen Menge von Organisations-Formen in verbindlicher weise, ist zum Zeitpunkt der Festlegung nicht möglich.

Used to categorize the organization.

Need to be able to track the kind of organization that this is - different organization types have different uses.

The kind(s) of organization that this is.

Definiert den allgemeinen Typ der Organisation.

Need to be able to track the kind of organization that this is - different organization types have different uses.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May 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.

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May 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.

The identification of the code system that defines the meaning of the symbol in the code.

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Need to refer to a particular code in the system.

A representation of the meaning of the code in the system, following the rules of the system.

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Very often the text is the same as a displayName of one of the codings.

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

The kind(s) of organization that this is.

Beschreibt die Art der Einrichtung nach IHE XDS Standards.

Need to be able to track the kind of organization that this is - different organization types have different uses.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May 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.

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May 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.

The identification of the code system that defines the meaning of the symbol in the code.

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Need to refer to a particular code in the system.

A representation of the meaning of the code in the system, following the rules of the system.

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Very often the text is the same as a displayName of one of the codings.