Implementation Guide
Telematikinfrastruktur (TI) Common
Version 1.1.0 - ballot

Resource Profile: TIPractitioner - Detailed Descriptions

Draft as of 2025-03-31

Definitions for the ti-practitioner resource profile.

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

0. Practitioner
Definition

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

ShortA person with a formal responsibility in the provisioning of healthcare or related services
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Practitioner.id
Definition

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

ShortLogical id of this artifact
Comments

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

Control0..1
Typeidstring
Is Modifierfalse
Must Supporttrue
Summarytrue
4. Practitioner.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadata about the resource
Control0..1
This element is affected by the following invariants: ele-1
TypeMeta
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Practitioner.meta.versionId
Definition

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

ShortVersion specific identifier
Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

Control0..1
Typeid
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Practitioner.meta.lastUpdated
Definition

When the resource last changed - e.g. when the version changed.

ShortWhen the resource version last changed
Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

Control0..1
Typeinstant
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Practitioner.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

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

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

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

Control0..*
This element is affected by the following invariants: ele-1
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

    An identifier that applies to this person in this role.

    ShortAn identifier for the person as this agent
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeIdentifier
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Often, specific identities are assigned for the agent.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on Practitioner.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ system
    • 16. Practitioner.identifier:TelematikID
      Slice NameTelematikID
      Definition

      An identifier that applies to this person in this role.

      ShortAn identifier for the person as this agent
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1*
      This element is affected by the following invariants: ele-1
      TypeIdentifier(Identifier-Profil für die Telematik-ID)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Often, specific identities are assigned for the agent.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. Practitioner.identifier:LANR
      Slice NameLANR
      Definition

      An identifier that applies to this person in this role.

      ShortAn identifier for the person as this agent
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeIdentifier(Identifier-Profil für die Abbildung einer lebenslangen Arztnummer)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Often, specific identities are assigned for the agent.

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

      The name(s) associated with the practitioner.

      ShortThe name(s) associated with the practitioner
      Comments

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

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

      1. There is more than 1 name
      2. Use = usual
      3. Period is current to the date of the usage
      4. Use = official
      5. Other order as decided by internal business rules.
      Control10..1*
      This element is affected by the following invariants: ele-1
      TypeHumanName
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

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

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

      Identifies the purpose for this name.

      Shortusual | official | temp | nickname | anonymous | old | maiden
      Comments

      Applications can assume that a name is current unless it explicitly says that it is temporary or old.

      Control0..1
      BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

      The use of a human name.

      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

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

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

      Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.

      ShortText representation of the full name
      Comments

      Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Requirements

      A renderable, unencoded form.

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

      The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

      ShortFamily name (often called 'Surname')
      Comments

      Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Alternate Namessurname
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. Practitioner.name.given
      Definition

      Given name.

      ShortGiven names (not always 'first'). Includes middle names
      Comments

      If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

      Control10..*
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Alternate Namesfirst name, middle name
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. Practitioner.name.prefix
      Definition

      Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

      ShortParts that come before the name
      Comments

      Note that FHIR strings SHALL NOT exceed 1MB in size

      Control0..*
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. Practitioner.name.suffix
      Definition

      Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

      ShortParts that come after the name
      Comments

      Note that FHIR strings SHALL NOT exceed 1MB in size

      Control0..*
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. Practitioner.gender
      Definition

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

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

      The gender of a person used for administrative purposes.

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

      Needed to address the person correctly.

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

      The date of birth for the practitioner.

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

      Needed for identification.

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

      Image of the person.

      ShortImage of the person
      Comments

      When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Signed Procedure Consent".

      Control0..*
      This element is affected by the following invariants: ele-1
      TypeAttachment
      Is Modifierfalse
      Must Supporttrue
      Requirements

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

      Invariantsatt-1: If the Attachment has data, it SHALL have a contentType (data.empty() or contentType.exists())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. Practitioner.qualification
      Definition

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

      ShortCertification, licenses, or training pertaining to the provision of care
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. Practitioner.qualification.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

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

      Control0..*
      This element is affected by the following invariants: ele-1
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      44. Practitioner.qualification.code
      Definition

      Coded representation of the qualification.

      ShortCoded representation of the qualification
      Comments

      Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

      Control1..1
      This element is affected by the following invariants: ele-1
      BindingUnless not suitable, these codes SHALL be taken from For example codes, see TI Practioner Qualificationshttp://terminology.hl7.org/ValueSet/v2-2.7-0360
      (extensible to https://gematik.de/fhir/directory/ValueSet/PractitionerQualificationVS)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. Practitioner.communication
      Definition

      A language the practitioner can use in patient communication.

      ShortA language the practitioner can use in patient communication
      Comments

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

      Control0..*
      This element is affected by the following invariants: ele-1
      BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

      Additional BindingsPurpose
      AllLanguagesMax Binding
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Requirements

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

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

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

      0. Practitioner
      2. Practitioner.id
      Must Supporttrue
      4. Practitioner.meta
      Must Supporttrue
      6. Practitioner.meta.versionId
      Must Supporttrue
      8. Practitioner.meta.lastUpdated
      Must Supporttrue
      10. Practitioner.identifier
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Must Supporttrue
      SlicingThis element introduces a set of slices on Practitioner.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ system
      • 12. Practitioner.identifier:TelematikID
        Slice NameTelematikID
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..1
        TypeIdentifier(Identifier-Profil für die Telematik-ID)
        Must Supporttrue
        14. Practitioner.identifier:LANR
        Slice NameLANR
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier(Identifier-Profil für die Abbildung einer lebenslangen Arztnummer)
        Must Supporttrue
        16. Practitioner.name
        Control1..1
        Must Supporttrue
        18. Practitioner.name.text
        Control1..?
        Must Supporttrue
        20. Practitioner.name.family
        Control1..?
        Must Supporttrue
        22. Practitioner.name.given
        Control1..?
        Must Supporttrue
        24. Practitioner.name.prefix
        Must Supporttrue
        26. Practitioner.name.suffix
        Must Supporttrue
        28. Practitioner.gender
        Must Supporttrue
        30. Practitioner.birthDate
        Must Supporttrue
        32. Practitioner.photo
        Must Supporttrue
        34. Practitioner.qualification
        Must Supporttrue
        36. Practitioner.qualification.code
        BindingUnless not suitable, these codes SHALL be taken from TI Practioner Qualifications
        (extensible to https://gematik.de/fhir/directory/ValueSet/PractitionerQualificationVS)
        Must Supporttrue
        38. Practitioner.communication
        Must Supporttrue

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

        0. Practitioner
        Definition

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

        ShortA person with a formal responsibility in the provisioning of healthcare or related services
        Control0..*
        Is Modifierfalse
        Summaryfalse
        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
        dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
        dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
        dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
        dom-6: A resource should have narrative for robust management (text.`div`.exists())
        2. Practitioner.id
        Definition

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

        ShortLogical id of this artifact
        Comments

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

        Control0..1
        Typeid
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        4. Practitioner.meta
        Definition

        The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

        ShortMetadata about the resource
        Control0..1
        TypeMeta
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        6. Practitioner.meta.id
        Definition

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

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        8. Practitioner.meta.extension
        Definition

        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.

        ShortAdditional content defined by implementations
        Comments

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

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

          The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

          ShortVersion specific identifier
          Comments

          The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

          Control0..1
          Typeid
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. Practitioner.meta.lastUpdated
          Definition

          When the resource last changed - e.g. when the version changed.

          ShortWhen the resource version last changed
          Comments

          This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

          Control0..1
          Typeinstant
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          14. Practitioner.meta.source
          Definition

          A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

          ShortIdentifies where the resource comes from
          Comments

          In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

          This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

          Control0..1
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          16. Practitioner.meta.profile
          Definition

          A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

          ShortProfiles this resource claims to conform to
          Comments

          It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

          Control0..*
          Typecanonical(StructureDefinition)
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          18. Practitioner.meta.security
          Definition

          Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

          ShortSecurity Labels applied to this resource
          Comments

          The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

          Control0..*
          This element is affected by the following invariants: ele-1
          BindingUnless not suitable, these codes SHALL be taken from All Security Labels
          (extensible to http://hl7.org/fhir/ValueSet/security-labels)

          Security Labels from the Healthcare Privacy and Security Classification System.

          TypeCoding
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          20. Practitioner.meta.tag
          Definition

          Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

          ShortTags applied to this resource
          Comments

          The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

          Control0..*
          This element is affected by the following invariants: ele-1
          BindingFor example codes, see CommonTags
          (example to http://hl7.org/fhir/ValueSet/common-tags)

          Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

          TypeCoding
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          22. Practitioner.implicitRules
          Definition

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

          ShortA set of rules under which this content was created
          Comments

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

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

          The base language in which the resource is written.

          ShortLanguage of the resource content
          Comments

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

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

          A human language.

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

          A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

          ShortText summary of the resource, for human interpretation
          Comments

          Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

          Control0..1
          TypeNarrative
          Is Modifierfalse
          Summaryfalse
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          28. Practitioner.contained
          Definition

          These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

          ShortContained, inline Resources
          Comments

          This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

          Control0..*
          TypeResource
          Is Modifierfalse
          Summaryfalse
          Alternate Namesinline resources, anonymous resources, contained resources
          30. Practitioner.extension
          Definition

          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.

          ShortAdditional content defined by implementations
          Comments

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

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

            May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
            Summaryfalse
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

              An identifier that applies to this person in this role.

              ShortAn identifier for the person as this agent
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..*
              This element is affected by the following invariants: ele-1
              TypeIdentifier
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

              Often, specific identities are assigned for the agent.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on Practitioner.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ system
              • 36. Practitioner.identifier:TelematikID
                Slice NameTelematikID
                Definition

                An identifier that applies to this person in this role.

                ShortAn identifier for the person as this agent
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeIdentifier(Identifier-Profil für die Telematik-ID)
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Requirements

                Often, specific identities are assigned for the agent.

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

                An identifier that applies to this person in this role.

                ShortAn identifier for the person as this agent
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..*
                This element is affected by the following invariants: ele-1
                TypeIdentifier(Identifier-Profil für die Abbildung einer lebenslangen Arztnummer)
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Requirements

                Often, specific identities are assigned for the agent.

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

                Whether this practitioner's record is in active use.

                ShortWhether this practitioner's record is in active use
                Comments

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

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

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

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

                The name(s) associated with the practitioner.

                ShortThe name(s) associated with the practitioner
                Comments

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

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

                1. There is more than 1 name
                2. Use = usual
                3. Period is current to the date of the usage
                4. Use = official
                5. Other order as decided by internal business rules.
                Control1..1
                This element is affected by the following invariants: ele-1
                TypeHumanName
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Requirements

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

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

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

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                46. Practitioner.name.extension
                Definition

                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.

                ShortAdditional content defined by implementations
                Comments

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

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

                  Identifies the purpose for this name.

                  Shortusual | official | temp | nickname | anonymous | old | maiden
                  Comments

                  Applications can assume that a name is current unless it explicitly says that it is temporary or old.

                  Control0..1
                  BindingThe codes SHALL be taken from NameUse
                  (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

                  The use of a human name.

                  Typecode
                  Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

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

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

                  Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.

                  ShortText representation of the full name
                  Comments

                  Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

                  Control1..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  A renderable, unencoded form.

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

                  The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

                  ShortFamily name (often called 'Surname')
                  Comments

                  Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

                  Control1..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Alternate Namessurname
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  54. Practitioner.name.given
                  Definition

                  Given name.

                  ShortGiven names (not always 'first'). Includes middle names
                  Comments

                  If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

                  Control1..*
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Alternate Namesfirst name, middle name
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  56. Practitioner.name.prefix
                  Definition

                  Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

                  ShortParts that come before the name
                  Comments

                  Note that FHIR strings SHALL NOT exceed 1MB in size

                  Control0..*
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  58. Practitioner.name.suffix
                  Definition

                  Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

                  ShortParts that come after the name
                  Comments

                  Note that FHIR strings SHALL NOT exceed 1MB in size

                  Control0..*
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  60. Practitioner.name.period
                  Definition

                  Indicates the period of time when this name was valid for the named person.

                  ShortTime period when name was/is in use
                  Comments

                  A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                  Period is not used for a duration (a measure of elapsed time). See Duration.

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypePeriod
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Allows names to be placed in historical context.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                  62. Practitioner.telecom
                  Definition

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

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

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

                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeContactPoint
                  Is Modifierfalse
                  Summarytrue
                  Requirements

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

                  Invariantscpt-2: A system is required if a value is provided. (value.empty() or system.exists())
                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  64. Practitioner.address
                  Definition

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

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

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

                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeAddress
                  Is Modifierfalse
                  Summarytrue
                  Requirements

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

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

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

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

                  The gender of a person used for administrative purposes.

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

                  Needed to address the person correctly.

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

                  The date of birth for the practitioner.

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

                  Needed for identification.

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

                  Image of the person.

                  ShortImage of the person
                  Comments

                  When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Signed Procedure Consent".

                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeAttachment
                  Is Modifierfalse
                  Must Supporttrue
                  Requirements

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

                  Invariantsatt-1: If the Attachment has data, it SHALL have a contentType (data.empty() or contentType.exists())
                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  72. Practitioner.qualification
                  Definition

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

                  ShortCertification, licenses, or training pertaining to the provision of care
                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeBackboneElement
                  Is Modifierfalse
                  Must Supporttrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  74. Practitioner.qualification.id
                  Definition

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

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  76. Practitioner.qualification.extension
                  Definition

                  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.

                  ShortAdditional content defined by implementations
                  Comments

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

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

                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

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

                    Control0..*
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                    Summarytrue
                    Requirements

                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                    Alternate Namesextensions, user content, modifiers
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    80. Practitioner.qualification.identifier
                    Definition

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

                    ShortAn identifier for this qualification for the practitioner
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..*
                    This element is affected by the following invariants: ele-1
                    TypeIdentifier
                    Is Modifierfalse
                    Requirements

                    Often, specific identities are assigned for the qualification.

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

                    Coded representation of the qualification.

                    ShortCoded representation of the qualification
                    Comments

                    Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                    Control1..1
                    This element is affected by the following invariants: ele-1
                    BindingUnless not suitable, these codes SHALL be taken from TI Practioner Qualifications
                    (extensible to https://gematik.de/fhir/directory/ValueSet/PractitionerQualificationVS)
                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supporttrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    84. Practitioner.qualification.period
                    Definition

                    Period during which the qualification is valid.

                    ShortPeriod during which the qualification is valid
                    Comments

                    A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                    Period is not used for a duration (a measure of elapsed time). See Duration.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypePeriod
                    Is Modifierfalse
                    Requirements

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

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                    86. Practitioner.qualification.issuer
                    Definition

                    Organization that regulates and issues the qualification.

                    ShortOrganization that regulates and issues the qualification
                    Comments

                    References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeReference(Organization)
                    Is Modifierfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                    88. Practitioner.communication
                    Definition

                    A language the practitioner can use in patient communication.

                    ShortA language the practitioner can use in patient communication
                    Comments

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

                    Control0..*
                    This element is affected by the following invariants: ele-1
                    BindingThe codes SHOULD be taken from CommonLanguages
                    (preferred to http://hl7.org/fhir/ValueSet/languages)

                    A human language.

                    Additional BindingsPurpose
                    AllLanguagesMax Binding
                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supporttrue
                    Requirements

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

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