Communication | Medplum
Elements
| Name | Required | Type | Description |
|---|---|---|---|
| identifier | Identifier[] | Unique identifier Details Business identifiers assigned to this communication by the performer or other systems which remain constant as the resource is updated and propagates from server to server. This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. |
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| instantiatesCanonical | canonical[] | Instantiates FHIR protocol or definition Details The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication. |
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| instantiatesUri | uri[] | Instantiates external protocol or definition Details The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication. This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier. |
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| basedOn | Reference |
Request fulfilled by this communication Details An order, proposal or plan fulfilled in whole or in part by this Communication. This must point to some sort of a 'Request' resource, such as CarePlan, CommunicationRequest, ServiceRequest, MedicationRequest, etc. |
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| partOf | Reference |
Part of this action Details Part of this action. |
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| inResponseTo | Reference< Communication >[] | Reply to Details Prior communication that this communication is in response to. |
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| status | ✓ | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Details The status of the transmission. This element is labeled as a modifier because the status contains the codes aborted and entered-in-error that mark the communication as not currently valid. |
| statusReason | CodeableConcept | Reason for current status Details Captures the reason for the current state of the Communication. This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here. |
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| category | CodeableConcept[] | Message category Details The type of message conveyed such as alert, notification, reminder, instruction, etc. There may be multiple axes of categorization and one communication may serve multiple purposes. |
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| priority | code | routine | urgent | asap | stat Details Characterizes how quickly the planned or in progress communication must be addressed. Includes concepts such as stat, urgent, routine. Used to prioritize workflow (such as which communication to read first) when the communication is planned or in progress. |
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| medium | CodeableConcept[] | A channel of communication Details A channel that was used for this communication (e.g. email, fax). |
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| subject | Reference< Patient | Group > | Focus of message Details The patient or group that was the focus of this communication. |
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| topic | CodeableConcept | Description of the purpose/content Details Description of the purpose/content, similar to a subject line in an email. Communication.topic.text can be used without any codings. |
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| about | Reference |
Resources that pertain to this communication Details Other resources that pertain to this communication and to which this communication should be associated. Don't use Communication.about element when a more specific element exists, such as basedOn or reasonReference. |
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| encounter | Reference< Encounter > | Encounter created as part of Details The Encounter during which this Communication was created or to which the creation of this record is tightly associated. This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. |
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| sent | dateTime | When sent Details The time when this communication was sent. |
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| received | dateTime | When received Details The time when this communication arrived at the destination. |
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| recipient | Reference< Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService >[] |
Message recipient Details The entity (e.g. person, organization, clinical information system, care team or device) which was the target of the communication. If receipts need to be tracked by an individual, a separate resource instance will need to be created for each recipient. Multiple recipient communications are intended where either receipts are not tracked (e.g. a mass mail-out) or a receipt is captured in aggregate (all emails confirmed received by a particular time). |
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| sender | Reference< Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService > |
Message sender Details The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication. |
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| reasonCode | CodeableConcept[] | Indication for message Details The reason or justification for the communication. Textual reasons can be captured using reasonCode.text. |
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| reasonReference | Reference< Condition | Observation | DiagnosticReport | DocumentReference >[] |
Why was communication done? Details Indicates another resource whose existence justifies this communication. |
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| payload | CommunicationPayload[] | Message payload Details Text, attachment(s), or resource(s) that was communicated to the recipient. |
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| id | string | Unique id for inter-element referencing Details Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
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| extension | Extension[] | Additional content defined by implementations Details 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. |
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| modifierExtension | Extension[] | Extensions that cannot be ignored even if unrecognized Details 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. |
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| content[x] | ✓ | string, Attachment, Reference |
Message part content Details A communicated content (or for multi-part communications, one portion of the communication). |
| note | Annotation[] | Comments made about the communication Details Additional notes or commentary about the communication by the sender, receiver or other interested parties. |
Communication is one of the event resources in the FHIR workflow specification.
This resource is a record of a communication even if it is planned or has failed. A communication is a conveyance of information from one entity, a sender, to another entity, a receiver. The sender and receivers may be patients, practitioners, related persons, organizations, or devices. Communication use cases include:
- A reminder or alert delivered to a responsible provider
- A recorded notification from the nurse to the on-call physician (or any other specified person) that a patient's temperature exceeds a value
- A notification to a public health agency of a patient presenting with a communicable disease reportable to the public health agency
- Patient educational material sent by a provider to a patient
- Unable to deliver lab results to ordering physician
Non-patient specific communication use cases may include:
- A nurse call from a hall bathroom
- Advisory for battery service from a pump
This resource is a record of a communication that has occurred. It does not represent the actual flow of communication. While AuditEvent can track electronic disclosures of information, it cannot track conversations, phone calls, letters and other interactions that are not system-to-system. And even for system-to-system communications, the specific end recipients might not be known. Furthermore, AuditEvents are not considered to be "part" of the patient record, while Communication instances are. The Communication resource is not used as a general audit mechanism to track every disclosure of every record. Rather, it is used when a clinician or other user wants to ensure a record of a particular communication is itself maintained as part of the reviewable health record.
Communication and Encounter
The Communication is about the transfer of information (which might or might not occur as part of an encounter), while Encounter is about the coming together (in person or virtually) of a Patient with a Practitioner. Communication does not deal with the duration of a call, it represents the fact that information was transferred at a particular point in time.