eHealthExchange Healthcare Directory Implementation Guide
1.0.5 - Release 1 United States of America flag

Resource Profile: EHxSubParticipant - Detailed Descriptions

Active as of 2024-03-29

Definitions for the eHxSubParticipant resource profile.

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

0. Organization
2. Organization.extension:HubServiceSubscriptions
Slice NameHubServiceSubscriptions
Control0..0
4. Organization.extension:AdministrativeStatus
Slice NameAdministrativeStatus
Control0..0
6. Organization.extension:HubRoutingStatus
Slice NameHubRoutingStatus
Control0..0
8. Organization.extension:org-managing-org
Slice Nameorg-managing-org
Control1..?
Must Supporttrue
10. Organization.type:sequoiaorgtype
Slice Namesequoiaorgtype
Control1..1
Must Supporttrue
Pattern Value{
  "coding" : [{
    "system" : "https://sequoiaproject.org/fhir/sphd/CodeSystem/OrganizationType",
    "code" : "Subparticipant"
  }]
}
12. Organization.address
Must Supporttrue
14. Organization.address.extension
Definition

An Extension

Control1..
TypeExtension(EHx Subparticipant Org Location, Org Location) (Extension Type: Reference(eHx Subparticipant Location))
Must Supporttrue
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())
16. Organization.contact
Control0..*
Must Supporttrue

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

0. Organization
Definition

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.

ShortA grouping of people or organizations with a common purpose
Control0..*
Is Modifierfalse
Must Supportfalse
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())
org-1: The organization SHALL at least have a name or an identifier, and possibly more than one ((identifier.count() + name.count()) > 0)
so-1: For any organization entry with endpoints, the Organization.id value must match the HCID OID contained under Organization.identifier (endpoint.exists() implies identifier.where(type.coding[0].code='HCID').first().value.substring(8)=id)
org-1: The organization SHALL at least have a name or an identifier, and possibly more than one ((identifier.count() + name.count()) > 0)
2. Organization.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()))
4. Organization.extension
Definition

An Extension


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.

ShortExtensionAdditional 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.

Control20..*
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 Organization.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. Organization.extension:Domains
    Slice NameDomains
    Definition

    An Extension

    ShortDomains
    Control1..*
    This element is affected by the following invariants: ele-1
    TypeExtension(Domains) (Extension Type: Coding)
    Is Modifierfalse
    Must Supporttrue
    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())
    8. Organization.extension:HubServiceSubscriptions
    Slice NameHubServiceSubscriptions
    Definition

    An Extension

    ShortHubServiceSubscription
    Control0..0
    This element is affected by the following invariants: ele-1
    TypeExtension(Hub Service Subscription) (Extension Type: Coding)
    Is Modifierfalse
    Must Supporttrue
    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())
    10. Organization.extension:AdministrativeStatus
    Slice NameAdministrativeStatus
    Definition

    An Extension

    ShortExtension
    Control0..0
    This element is affected by the following invariants: ele-1
    TypeExtension(Administrative Status) (Extension Type: Coding)
    Is Modifierfalse
    Must Supporttrue
    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())
    12. Organization.extension:HubRoutingStatus
    Slice NameHubRoutingStatus
    Definition

    An Extension

    ShortExtension
    Control0..0
    This element is affected by the following invariants: ele-1
    TypeExtension(Hub Routing Status) (Extension Type: Coding)
    Is Modifierfalse
    Must Supporttrue
    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())
    14. Organization.extension:InitiatorOnly
    Slice NameInitiatorOnly
    Definition

    An Extension

    ShortExtension
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Initiator Only) (Extension Type: Coding)
    Is Modifierfalse
    Must Supporttrue
    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())
    16. Organization.extension:org-managing-org
    Slice Nameorg-managing-org
    Definition

    An Extension

    ShortExtension
    Control1..1
    This element is affected by the following invariants: ele-1
    TypeExtension(OrgManagingOrg) (Extension Type: Reference(Sequoia Organization))
    Is Modifierfalse
    Must Supporttrue
    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())
    18. Organization.extension:PurposesOfUse
    Slice NamePurposesOfUse
    Definition

    An Extension

    ShortExtension
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(Purposes Of Use) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    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())
    20. Organization.extension:PurposesOfUse.url
    Definition

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

    Shortidentifies the meaning of the extension
    Comments

    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.

    Control1..1
    Typeuri
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    Fixed Valuehttps://sequoiaproject.org/fhir/sphd/StructureDefinition/PurposesOfUse
    22. Organization.extension:PurposesOfUse.value[x]
    Definition

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

    ShortValue of extension
    Control10..1
    BindingThe codes SHALL be taken from For codes, see Purpose Of Use
    (required to https://sequoiaproject.org/fhir/sphd/ValueSet/PurposeOfUse)
    TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. Organization.extension:StateOfOperation
    Slice NameStateOfOperation
    Definition

    An Extension

    ShortExtension
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(StateOfOperation) (Extension Type: Address)
    Is Modifierfalse
    Must Supporttrue
    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())
    26. Organization.extension:UseCases
    Slice NameUseCases
    Definition

    An Extension

    ShortExtension
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(UseCases) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    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())
    28. Organization.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())
    30. Organization.identifier
    Definition

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

    ShortIdentifies this organization across multiple systems
    Comments

    NPI preferred.

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control10..*
    This element is affected by the following invariants: org-1
    TypeIdentifier
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

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

    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 Organization.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • pattern @ $this
    • 32. Organization.identifier:NPI
      Slice NameNPI
      Definition

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

      ShortNational Provider Identifier (NPI)Identifies this organization across multiple systems
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1*
      This element is affected by the following invariants: org-1
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

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

      Pattern Value{
        "system" : "http://hl7.org/fhir/sid/us-npi"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. Organization.identifier:CLIA
      Slice NameCLIA
      Definition

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

      ShortClinical Laboratory Improvement Amendments (CLIA) Number for laboratoriesIdentifies this organization across multiple systems
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1*
      This element is affected by the following invariants: org-1
      TypeIdentifier
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Requirements

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

      Pattern Value{
        "system" : "urn:oid:2.16.840.1.113883.4.7"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. Organization.identifier:CCN
      Slice NameCCN
      Definition

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

      ShortCMS Certification Number (CCN)Identifies this organization across multiple systems
      Comments

      NPI preferred.

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

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

      Pattern Value{
        "system" : "urn:oid:2.16.840.1.113883.4.336"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. Organization.identifier:HCID
      Slice NameHCID
      Definition

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

      ShortOID (such as a Home Community ID) or UUIDIdentifies this organization across multiple systems
      Comments

      NPI preferred.

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control10..1*
      This element is affected by the following invariants: org-1
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

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

      Pattern Value{
        "type" : {
          "coding" : [{
            "system" : "https://sequoiaproject.org/fhir/sphd/CodeSystem/SequoiaIdentifierCodes",
            "code" : "HCID"
          }]
        },
        "system" : "urn:ietf:rfc:3986"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. Organization.identifier:AAID
      Slice NameAAID
      Definition

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

      ShortOID (such as an Assiging Authority ID) or UUIDIdentifies this organization across multiple systems
      Comments

      NPI preferred.

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

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

      Pattern Value{
        "type" : {
          "coding" : [{
            "system" : "https://sequoiaproject.org/fhir/sphd/CodeSystem/SequoiaIdentifierCodes",
            "code" : "AAID"
          }]
        },
        "system" : "urn:ietf:rfc:3986"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. Organization.identifier:DOA
      Slice NameDOA
      Definition

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

      ShortOID (such as a Home Community ID) or UUID used to represent delegation of authorityIdentifies this organization across multiple systems
      Comments

      NPI preferred.

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control10..1*
      This element is affected by the following invariants: org-1
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

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

      Pattern Value{
        "type" : {
          "coding" : [{
            "system" : "https://sequoiaproject.org/fhir/sphd/CodeSystem/SequoiaIdentifierCodes",
            "code" : "DOA"
          }]
        },
        "system" : "urn:ietf:rfc:3986"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. Organization.active
      Definition

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

      ShortWhether the organization's record is still in active use
      Comments

      This active flag is not intended to be used to mark an organization as temporarily closed or under construction. Instead the Location(s) within the Organization should have the suspended status. If further details of the reason for the suspension are required, then an extension on this element should be used.

      This element is labeled as a modifier because it may be used to mark that the resource was created in error.

      Control10..1
      Typeboolean
      Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Requirements

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

      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()))
      46. Organization.type
      Definition

      The kind(s) of organization that this is.

      ShortKind of organization
      Comments

      Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes

      When considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center.

      We expect that some jurisdictions will profile this optionality to be a single cardinality.

      Control20..*
      BindingFor example codes, see OrganizationTypehttp://hl7.org/fhir/ValueSet/organization-type
      (example to http://hl7.org/fhir/ValueSet/organization-type)

      Used to categorize the organization.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

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

      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 Organization.type. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • pattern @ $this
      • 48. Organization.type:sequoiaorgtype
        Slice Namesequoiaorgtype
        Definition

        The kind(s) of organization that this is.

        ShortKind of organization
        Comments

        Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes

        When considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center.

        We expect that some jurisdictions will profile this optionality to be a single cardinality.

        Control10..1*
        BindingThe codes SHALL be taken from For example codes, see Organization Typehttp://hl7.org/fhir/ValueSet/organization-type
        (required to https://sequoiaproject.org/fhir/sphd/ValueSet/OrganizationType)
        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

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

        Pattern Value{
          "coding" : [{
            "system" : "https://sequoiaproject.org/fhir/sphd/CodeSystem/OrganizationType",
            "code" : "Subparticipant"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. Organization.type:hl7orgrole
        Slice Namehl7orgrole
        Definition

        The kind(s) of organization that this is.

        ShortKind of organization
        Comments

        Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes

        When considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center.

        We expect that some jurisdictions will profile this optionality to be a single cardinality.

        Control0..*
        BindingThe codes SHALL be taken from For example codes, see OrganizationAffiliationRolehttp://hl7.org/fhir/ValueSet/organization-type
        (required to http://hl7.org/fhir/ValueSet/organization-role)
        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

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

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

        A name associated with the organization.

        ShortName used for the organization
        Comments

        If the name of an organization changes, consider putting the old name in the alias column so that it can still be located through searches.

        Control10..1
        This element is affected by the following invariants: org-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

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

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

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

        ShortA list of alternate names that the organization is known as, or was known as in the past
        Comments

        There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the organization.

        Control0..*
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summaryfalse
        Requirements

        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.

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

        A contact detail for the organization.

        ShortA contact detail for the organization
        Comments

        The use code 'home' is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself.

        Control0..*
        This element is affected by the following invariants: org-3
        TypeContactPoint
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

        Human contact for the organization.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        org-3: The telecom of an organization can never be of use 'home' (where(use = 'home').empty())
        org-3: The telecom of an organization can never be of use 'home' (where(use = 'home').empty())
        SlicingThis element introduces a set of slices on Organization.telecom. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • value @ system
        • 58. Organization.telecom:phone
          Slice Namephone
          Definition

          A contact detail for the organization.

          ShortA contact detail for the organization
          Comments

          The use code 'home' is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself.

          Control0..1*
          This element is affected by the following invariants: org-3
          TypeContactPoint
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          Human contact for the organization.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          org-3: The telecom of an organization can never be of use 'home' (where(use = 'home').empty())
          org-3: The telecom of an organization can never be of use 'home' (where(use = 'home').empty())
          60. Organization.telecom:phone.system
          Definition

          Telecommunications form for contact point - what communications system is required to make use of the contact.

          Shortphone | fax | email | pager | url | sms | other
          Control10..1
          This element is affected by the following invariants: cpt-2
          BindingThe codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
          (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

          Telecommunications form for contact point.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Fixed Valuephone
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          62. Organization.telecom:phone.value
          Definition

          The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

          ShortThe actual contact point details
          Comments

          Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

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

          Need to support legacy numbers that are not in a tightly controlled format.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. Organization.telecom:phone.use
          Definition

          Identifies the purpose for the contact point.

          Shorthome | work | temp | old | mobile - purpose of this contact point
          Comments

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

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

          Use of contact point.

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

          Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          66. Organization.telecom:email
          Slice Nameemail
          Definition

          A contact detail for the organization.

          ShortA contact detail for the organization
          Comments

          The use code 'home' is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself.

          Control0..1*
          This element is affected by the following invariants: org-3
          TypeContactPoint
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          Human contact for the organization.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          org-3: The telecom of an organization can never be of use 'home' (where(use = 'home').empty())
          org-3: The telecom of an organization can never be of use 'home' (where(use = 'home').empty())
          68. Organization.telecom:email.system
          Definition

          Telecommunications form for contact point - what communications system is required to make use of the contact.

          Shortphone | fax | email | pager | url | sms | other
          Control10..1
          This element is affected by the following invariants: cpt-2
          BindingThe codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
          (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

          Telecommunications form for contact point.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Fixed Valueemail
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          70. Organization.telecom:email.value
          Definition

          The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

          ShortThe actual contact point details
          Comments

          Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

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

          Need to support legacy numbers that are not in a tightly controlled format.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          72. Organization.telecom:email.use
          Definition

          Identifies the purpose for the contact point.

          Shorthome | work | temp | old | mobile - purpose of this contact point
          Comments

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

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

          Use of contact point.

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

          Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

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

          An address for the organization.

          ShortAn address for the organization
          Comments

          Organization may have multiple addresses with different uses or applicable periods. The use code 'home' is not to be used.

          Control10..*
          This element is affected by the following invariants: org-2
          TypeAddress
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          org-2: An address of an organization can never be of use 'home' (where(use = 'home').empty())
          org-2: An address of an organization can never be of use 'home' (where(use = 'home').empty())
          76. Organization.address.extension
          Definition

          An Extension


          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.

          ShortExtension
          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.

          Control1..*
          TypeExtension(EHx Subparticipant Org Location) (Extension Type: Reference(eHx Subparticipant Location))
          Is Modifierfalse
          Must Supporttrue
          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())
          78. Organization.address.use
          Definition

          The purpose of this address.

          Shorthome | work | temp | old | billing - purpose of this address
          Comments

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

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

          The use of an address.

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

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

          Example<br/><b>General</b>:home
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          80. Organization.address.text
          Definition

          Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

          ShortText representation of the address
          Comments

          Can provide both a text representation and parts. Applications updating an address 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.

          Example<br/><b>General</b>:137 Nowhere Street, Erewhon 9132
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          82. Organization.address.line
          Definition

          This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

          ShortStreet name, number, direction & P.O. Box etc.
          Control0..1*
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Example<br/><b>General</b>:137 Nowhere Street
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          84. Organization.address.city
          Definition

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

          ShortName of city, town etc.
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Alternate NamesMunicpality
          Example<br/><b>General</b>:Erewhon
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          86. Organization.address.state
          Definition

          Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

          ShortSub-unit of country (abbreviations ok)
          Control0..1
          BindingUnless not suitable, these codes SHALL be taken from For codes, see USPS Two Letter Alphabetic Codes
          (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state)

          Two letter USPS alphabetic codes.

          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Alternate NamesProvince, Territory
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          88. Organization.address.postalCode
          Definition

          A postal code designating a region defined by the postal service.

          ShortUS Zip CodesPostal code for area
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Alternate NamesZip
          Example<br/><b>General</b>:9132
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          90. Organization.address.country
          Definition

          Country - a nation as commonly understood or generally accepted.

          ShortMust be an ISO 3166 3 letter codeCountry (e.g. can be ISO 3166 2 or 3 letter code)
          Comments

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

          Control10..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Fixed ValueUS
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          92. Organization.partOf
          Definition

          The organization of which this organization forms a part.

          ShortThe organization of which this organization forms a part
          Control0..1
          TypeReference(eHx Organization, Organization)
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

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

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

          Contact for the organization for a certain purpose.

          ShortContact for the organization for a certain purpose
          Comments

          Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use.

          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          96. Organization.contact.extension:company
          Slice Namecompany
          Definition

          An Extension

          ShortExtension
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(Company) (Extension Type: string)
          Is Modifierfalse
          Must Supporttrue
          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())
          98. Organization.contact.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())
          100. Organization.contact.telecom
          Definition

          A contact detail (e.g. a telephone number or an email address) by which the party may be contacted.

          ShortContact details (telephone, email, etc.) for a contact
          Control0..*
          TypeContactPoint
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          People have (primary) ways to contact them in some way such as phone, email.

          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 Organization.contact.telecom. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • value @ system
          • 102. Organization.contact.telecom:phone
            Slice Namephone
            Definition

            A contact detail (e.g. a telephone number or an email address) by which the party may be contacted.

            ShortContact details (telephone, email, etc.) for a contact
            Control0..*
            TypeContactPoint
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            People have (primary) ways to contact them in some way such as phone, email.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            104. Organization.contact.telecom:phone.system
            Definition

            Telecommunications form for contact point - what communications system is required to make use of the contact.

            Shortphone | fax | email | pager | url | sms | other
            Control0..1
            This element is affected by the following invariants: cpt-2
            BindingThe codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
            (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

            Telecommunications form for contact point.

            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Fixed Valuephone
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            106. Organization.contact.telecom:phone.use
            Definition

            Identifies the purpose for the contact point.

            Shorthome | work | temp | old | mobile - purpose of this contact point
            Comments

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

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

            Use of contact point.

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

            Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            108. Organization.contact.telecom:email
            Slice Nameemail
            Definition

            A contact detail (e.g. a telephone number or an email address) by which the party may be contacted.

            ShortContact details (telephone, email, etc.) for a contact
            Control0..1*
            TypeContactPoint
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            People have (primary) ways to contact them in some way such as phone, email.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            110. Organization.contact.telecom:email.system
            Definition

            Telecommunications form for contact point - what communications system is required to make use of the contact.

            Shortphone | fax | email | pager | url | sms | other
            Control0..1
            This element is affected by the following invariants: cpt-2
            BindingThe codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
            (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

            Telecommunications form for contact point.

            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Fixed Valueemail
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            112. Organization.contact.telecom:email.use
            Definition

            Identifies the purpose for the contact point.

            Shorthome | work | temp | old | mobile - purpose of this contact point
            Comments

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

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

            Use of contact point.

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

            Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

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

            Visiting or postal addresses for the contact.

            ShortVisiting or postal addresses for the contact
            Control0..1
            TypeAddress
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            May need to keep track of a contact party's address for contacting, billing or reporting requirements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            116. Organization.contact.address.use
            Definition

            The purpose of this address.

            Shorthome | work | temp | old | billing - purpose of this address
            Comments

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

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

            The use of an address.

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

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

            Example<br/><b>General</b>:home
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            118. Organization.contact.address.line
            Definition

            This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

            ShortStreet name, number, direction & P.O. Box etc.
            Control0..1*
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Example<br/><b>General</b>:137 Nowhere Street
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            120. Organization.endpoint
            Definition

            Technical endpoints providing access to services operated for the organization.

            ShortTechnical endpoints providing access to services operated for the organization
            Control0..*
            TypeReference(eHx Endpoint, Endpoint)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            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.

            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. Organization
            Definition

            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.

            ShortA grouping of people or organizations with a common purpose
            Control0..*
            Is Modifierfalse
            Must Supportfalse
            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())
            org-1: The organization SHALL at least have a name or an identifier, and possibly more than one ((identifier.count() + name.count()) > 0)
            so-1: For any organization entry with endpoints, the Organization.id value must match the HCID OID contained under Organization.identifier (endpoint.exists() implies identifier.where(type.coding[0].code='HCID').first().value.substring(8)=id)
            2. Organization.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
            Summarytrue
            4. Organization.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
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            6. Organization.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()))
            8. Organization.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()))
            10. Organization.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()))
            12. Organization.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
            14. Organization.extension
            Definition

            An Extension

            ShortExtension
            Control2..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            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 Organization.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 16. Organization.extension:Domains
              Slice NameDomains
              Definition

              An Extension

              ShortDomains
              Control1..*
              This element is affected by the following invariants: ele-1
              TypeExtension(Domains) (Extension Type: Coding)
              Is Modifierfalse
              Must Supporttrue
              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())
              18. Organization.extension:HubServiceSubscriptions
              Slice NameHubServiceSubscriptions
              Definition

              An Extension

              ShortHubServiceSubscription
              Control0..0
              This element is affected by the following invariants: ele-1
              TypeExtension(Hub Service Subscription) (Extension Type: Coding)
              Is Modifierfalse
              Must Supporttrue
              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())
              20. Organization.extension:AdministrativeStatus
              Slice NameAdministrativeStatus
              Definition

              An Extension

              ShortExtension
              Control0..0
              This element is affected by the following invariants: ele-1
              TypeExtension(Administrative Status) (Extension Type: Coding)
              Is Modifierfalse
              Must Supporttrue
              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())
              22. Organization.extension:HubRoutingStatus
              Slice NameHubRoutingStatus
              Definition

              An Extension

              ShortExtension
              Control0..0
              This element is affected by the following invariants: ele-1
              TypeExtension(Hub Routing Status) (Extension Type: Coding)
              Is Modifierfalse
              Must Supporttrue
              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())
              24. Organization.extension:InitiatorOnly
              Slice NameInitiatorOnly
              Definition

              An Extension

              ShortExtension
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(Initiator Only) (Extension Type: Coding)
              Is Modifierfalse
              Must Supporttrue
              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())
              26. Organization.extension:org-managing-org
              Slice Nameorg-managing-org
              Definition

              An Extension

              ShortExtension
              Control1..1
              This element is affected by the following invariants: ele-1
              TypeExtension(OrgManagingOrg) (Extension Type: Reference(Sequoia Organization))
              Is Modifierfalse
              Must Supporttrue
              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())
              28. Organization.extension:PurposesOfUse
              Slice NamePurposesOfUse
              Definition

              An Extension

              ShortExtension
              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension(Purposes Of Use) (Extension Type: CodeableConcept)
              Is Modifierfalse
              Must Supporttrue
              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())
              30. Organization.extension:PurposesOfUse.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
              32. Organization.extension:PurposesOfUse.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 Organization.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 34. Organization.extension:PurposesOfUse.url
                Definition

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

                Shortidentifies the meaning of the extension
                Comments

                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.

                Control1..1
                Typeuri
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                Fixed Valuehttps://sequoiaproject.org/fhir/sphd/StructureDefinition/PurposesOfUse
                36. Organization.extension:PurposesOfUse.value[x]
                Definition

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

                ShortValue of extension
                Control1..1
                BindingThe codes SHALL be taken from Purpose Of Use
                (required to https://sequoiaproject.org/fhir/sphd/ValueSet/PurposeOfUse)
                TypeCodeableConcept
                [x] NoteSee Choice of Data Types for further information about how to use [x]
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                38. Organization.extension:StateOfOperation
                Slice NameStateOfOperation
                Definition

                An Extension

                ShortExtension
                Control0..*
                This element is affected by the following invariants: ele-1
                TypeExtension(StateOfOperation) (Extension Type: Address)
                Is Modifierfalse
                Must Supporttrue
                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())
                40. Organization.extension:UseCases
                Slice NameUseCases
                Definition

                An Extension

                ShortExtension
                Control0..*
                This element is affected by the following invariants: ele-1
                TypeExtension(UseCases) (Extension Type: CodeableConcept)
                Is Modifierfalse
                Must Supporttrue
                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())
                42. Organization.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())
                44. Organization.identifier
                Definition

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

                ShortIdentifies this organization across multiple systems
                Comments

                NPI preferred.

                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control1..*
                This element is affected by the following invariants: org-1
                TypeIdentifier
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Requirements

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

                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 Organization.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
                • pattern @ $this
                • 46. Organization.identifier:NPI
                  Slice NameNPI
                  Definition

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

                  ShortNational Provider Identifier (NPI)
                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..1
                  This element is affected by the following invariants: org-1
                  TypeIdentifier
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

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

                  Pattern Value{
                    "system" : "http://hl7.org/fhir/sid/us-npi"
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  48. Organization.identifier:CLIA
                  Slice NameCLIA
                  Definition

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

                  ShortClinical Laboratory Improvement Amendments (CLIA) Number for laboratories
                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..1
                  This element is affected by the following invariants: org-1
                  TypeIdentifier
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Requirements

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

                  Pattern Value{
                    "system" : "urn:oid:2.16.840.1.113883.4.7"
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  50. Organization.identifier:CCN
                  Slice NameCCN
                  Definition

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

                  ShortCMS Certification Number (CCN)
                  Comments

                  NPI preferred.

                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..1
                  This element is affected by the following invariants: org-1
                  TypeIdentifier
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

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

                  Pattern Value{
                    "system" : "urn:oid:2.16.840.1.113883.4.336"
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  52. Organization.identifier:HCID
                  Slice NameHCID
                  Definition

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

                  ShortOID (such as a Home Community ID) or UUID
                  Comments

                  NPI preferred.

                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control1..1
                  This element is affected by the following invariants: org-1
                  TypeIdentifier
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

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

                  Pattern Value{
                    "type" : {
                      "coding" : [{
                        "system" : "https://sequoiaproject.org/fhir/sphd/CodeSystem/SequoiaIdentifierCodes",
                        "code" : "HCID"
                      }]
                    },
                    "system" : "urn:ietf:rfc:3986"
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  54. Organization.identifier:AAID
                  Slice NameAAID
                  Definition

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

                  ShortOID (such as an Assiging Authority ID) or UUID
                  Comments

                  NPI preferred.

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

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

                  Pattern Value{
                    "type" : {
                      "coding" : [{
                        "system" : "https://sequoiaproject.org/fhir/sphd/CodeSystem/SequoiaIdentifierCodes",
                        "code" : "AAID"
                      }]
                    },
                    "system" : "urn:ietf:rfc:3986"
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  56. Organization.identifier:DOA
                  Slice NameDOA
                  Definition

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

                  ShortOID (such as a Home Community ID) or UUID used to represent delegation of authority
                  Comments

                  NPI preferred.

                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control1..1
                  This element is affected by the following invariants: org-1
                  TypeIdentifier
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

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

                  Pattern Value{
                    "type" : {
                      "coding" : [{
                        "system" : "https://sequoiaproject.org/fhir/sphd/CodeSystem/SequoiaIdentifierCodes",
                        "code" : "DOA"
                      }]
                    },
                    "system" : "urn:ietf:rfc:3986"
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  58. Organization.active
                  Definition

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

                  ShortWhether the organization's record is still in active use
                  Comments

                  This active flag is not intended to be used to mark an organization as temporarily closed or under construction. Instead the Location(s) within the Organization should have the suspended status. If further details of the reason for the suspension are required, then an extension on this element should be used.

                  This element is labeled as a modifier because it may be used to mark that the resource was created in error.

                  Control1..1
                  Typeboolean
                  Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

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

                  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()))
                  60. Organization.type
                  Definition

                  The kind(s) of organization that this is.

                  ShortKind of organization
                  Comments

                  Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes

                  When considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center.

                  We expect that some jurisdictions will profile this optionality to be a single cardinality.

                  Control2..*
                  BindingFor example codes, see OrganizationType
                  (example to http://hl7.org/fhir/ValueSet/organization-type)

                  Used to categorize the organization.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

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

                  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 Organization.type. The slices are unordered and Open, and can be differentiated using the following discriminators:
                  • pattern @ $this
                  • 62. Organization.type:sequoiaorgtype
                    Slice Namesequoiaorgtype
                    Definition

                    The kind(s) of organization that this is.

                    ShortKind of organization
                    Comments

                    Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes

                    When considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center.

                    We expect that some jurisdictions will profile this optionality to be a single cardinality.

                    Control1..1
                    BindingThe codes SHALL be taken from Organization Type
                    (required to https://sequoiaproject.org/fhir/sphd/ValueSet/OrganizationType)
                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

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

                    Pattern Value{
                      "coding" : [{
                        "system" : "https://sequoiaproject.org/fhir/sphd/CodeSystem/OrganizationType",
                        "code" : "Subparticipant"
                      }]
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    64. Organization.type:hl7orgrole
                    Slice Namehl7orgrole
                    Definition

                    The kind(s) of organization that this is.

                    ShortKind of organization
                    Comments

                    Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes

                    When considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center.

                    We expect that some jurisdictions will profile this optionality to be a single cardinality.

                    Control0..*
                    BindingThe codes SHALL be taken from OrganizationAffiliationRole
                    (required to http://hl7.org/fhir/ValueSet/organization-role)
                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

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

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

                    A name associated with the organization.

                    ShortName used for the organization
                    Comments

                    If the name of an organization changes, consider putting the old name in the alias column so that it can still be located through searches.

                    Control1..1
                    This element is affected by the following invariants: org-1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

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

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

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

                    ShortA list of alternate names that the organization is known as, or was known as in the past
                    Comments

                    There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the organization.

                    Control0..*
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summaryfalse
                    Requirements

                    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.

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

                    A contact detail for the organization.

                    ShortA contact detail for the organization
                    Comments

                    The use code 'home' is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself.

                    Control0..*
                    This element is affected by the following invariants: org-3
                    TypeContactPoint
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Requirements

                    Human contact for the organization.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    org-3: The telecom of an organization can never be of use 'home' (where(use = 'home').empty())
                    SlicingThis element introduces a set of slices on Organization.telecom. The slices are unordered and Open, and can be differentiated using the following discriminators:
                    • value @ system
                    • 72. Organization.telecom:phone
                      Slice Namephone
                      Definition

                      A contact detail for the organization.

                      ShortA contact detail for the organization
                      Comments

                      The use code 'home' is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself.

                      Control0..1
                      This element is affected by the following invariants: org-3
                      TypeContactPoint
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Requirements

                      Human contact for the organization.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      org-3: The telecom of an organization can never be of use 'home' (where(use = 'home').empty())
                      74. Organization.telecom:phone.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. Organization.telecom:phone.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 Organization.telecom.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 78. Organization.telecom:phone.system
                        Definition

                        Telecommunications form for contact point - what communications system is required to make use of the contact.

                        Shortphone | fax | email | pager | url | sms | other
                        Control1..1
                        This element is affected by the following invariants: cpt-2
                        BindingThe codes SHALL be taken from ContactPointSystem
                        (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

                        Telecommunications form for contact point.

                        Typecode
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Fixed Valuephone
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        80. Organization.telecom:phone.value
                        Definition

                        The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

                        ShortThe actual contact point details
                        Comments

                        Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

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

                        Need to support legacy numbers that are not in a tightly controlled format.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        82. Organization.telecom:phone.use
                        Definition

                        Identifies the purpose for the contact point.

                        Shorthome | work | temp | old | mobile - purpose of this contact point
                        Comments

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

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

                        Use of contact point.

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

                        Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        84. Organization.telecom:phone.rank
                        Definition

                        Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

                        ShortSpecify preferred order of use (1 = highest)
                        Comments

                        Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

                        Control0..1
                        TypepositiveInt
                        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()))
                        86. Organization.telecom:phone.period
                        Definition

                        Time period when the contact point was/is in use.

                        ShortTime period when the contact point was/is in use
                        Control0..1
                        TypePeriod
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        88. Organization.telecom:email
                        Slice Nameemail
                        Definition

                        A contact detail for the organization.

                        ShortA contact detail for the organization
                        Comments

                        The use code 'home' is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself.

                        Control0..1
                        This element is affected by the following invariants: org-3
                        TypeContactPoint
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Requirements

                        Human contact for the organization.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        org-3: The telecom of an organization can never be of use 'home' (where(use = 'home').empty())
                        90. Organization.telecom:email.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
                        92. Organization.telecom:email.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 Organization.telecom.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 94. Organization.telecom:email.system
                          Definition

                          Telecommunications form for contact point - what communications system is required to make use of the contact.

                          Shortphone | fax | email | pager | url | sms | other
                          Control1..1
                          This element is affected by the following invariants: cpt-2
                          BindingThe codes SHALL be taken from ContactPointSystem
                          (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

                          Telecommunications form for contact point.

                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Fixed Valueemail
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          96. Organization.telecom:email.value
                          Definition

                          The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

                          ShortThe actual contact point details
                          Comments

                          Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

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

                          Need to support legacy numbers that are not in a tightly controlled format.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          98. Organization.telecom:email.use
                          Definition

                          Identifies the purpose for the contact point.

                          Shorthome | work | temp | old | mobile - purpose of this contact point
                          Comments

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

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

                          Use of contact point.

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

                          Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          100. Organization.telecom:email.rank
                          Definition

                          Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

                          ShortSpecify preferred order of use (1 = highest)
                          Comments

                          Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

                          Control0..1
                          TypepositiveInt
                          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()))
                          102. Organization.telecom:email.period
                          Definition

                          Time period when the contact point was/is in use.

                          ShortTime period when the contact point was/is in use
                          Control0..1
                          TypePeriod
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          104. Organization.address
                          Definition

                          An address for the organization.

                          ShortAn address for the organization
                          Comments

                          Organization may have multiple addresses with different uses or applicable periods. The use code 'home' is not to be used.

                          Control1..*
                          This element is affected by the following invariants: org-2
                          TypeAddress
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          org-2: An address of an organization can never be of use 'home' (where(use = 'home').empty())
                          106. Organization.address.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
                          108. Organization.address.extension
                          Definition

                          An Extension

                          ShortExtension
                          Control1..*
                          TypeExtension(EHx Subparticipant Org Location) (Extension Type: Reference(eHx Subparticipant Location))
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          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())
                          110. Organization.address.use
                          Definition

                          The purpose of this address.

                          Shorthome | work | temp | old | billing - purpose of this address
                          Comments

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

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

                          The use of an address.

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

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

                          Example<br/><b>General</b>:home
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          112. Organization.address.type
                          Definition

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

                          Shortpostal | physical | both
                          Comments

                          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).

                          Control0..1
                          BindingThe codes SHALL be taken from AddressType
                          (required to http://hl7.org/fhir/ValueSet/address-type|4.0.1)

                          The type of an address (physical / postal).

                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Example<br/><b>General</b>:both
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          114. Organization.address.text
                          Definition

                          Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

                          ShortText representation of the address
                          Comments

                          Can provide both a text representation and parts. Applications updating an address 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.

                          Example<br/><b>General</b>:137 Nowhere Street, Erewhon 9132
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          116. Organization.address.line
                          Definition

                          This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

                          ShortStreet name, number, direction & P.O. Box etc.
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Example<br/><b>General</b>:137 Nowhere Street
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          118. Organization.address.city
                          Definition

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

                          ShortName of city, town etc.
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Alternate NamesMunicpality
                          Example<br/><b>General</b>:Erewhon
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          120. Organization.address.district
                          Definition

                          The name of the administrative area (county).

                          ShortDistrict name (aka county)
                          Comments

                          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.

                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Alternate NamesCounty
                          Example<br/><b>General</b>:Madison
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          122. Organization.address.state
                          Definition

                          Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

                          ShortSub-unit of country (abbreviations ok)
                          Control0..1
                          BindingUnless not suitable, these codes SHALL be taken from USPS Two Letter Alphabetic Codes
                          (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state)

                          Two letter USPS alphabetic codes.

                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Alternate NamesProvince, Territory
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          124. Organization.address.postalCode
                          Definition

                          A postal code designating a region defined by the postal service.

                          ShortUS Zip Codes
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Alternate NamesZip
                          Example<br/><b>General</b>:9132
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          126. Organization.address.country
                          Definition

                          Country - a nation as commonly understood or generally accepted.

                          ShortMust be an ISO 3166 3 letter code
                          Comments

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

                          Control1..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Fixed ValueUS
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          128. Organization.address.period
                          Definition

                          Time period when address was/is in use.

                          ShortTime period when address was/is in use
                          Control0..1
                          TypePeriod
                          Is Modifierfalse
                          Summarytrue
                          Requirements

                          Allows addresses to be placed in historical context.

                          Example<br/><b>General</b>:{ "start" : "2010-03-23", "end" : "2010-07-01" }
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          130. Organization.partOf
                          Definition

                          The organization of which this organization forms a part.

                          ShortThe organization of which this organization forms a part
                          Control0..1
                          TypeReference(eHx Organization)
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Requirements

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

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

                          Contact for the organization for a certain purpose.

                          ShortContact for the organization for a certain purpose
                          Comments

                          Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use.

                          Control0..*
                          TypeBackboneElement
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          134. Organization.contact.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
                          136. Organization.contact.extension
                          Definition

                          An Extension

                          ShortExtension
                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          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 Organization.contact.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 138. Organization.contact.extension:company
                            Slice Namecompany
                            Definition

                            An Extension

                            ShortExtension
                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeExtension(Company) (Extension Type: string)
                            Is Modifierfalse
                            Must Supporttrue
                            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())
                            140. Organization.contact.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())
                            142. Organization.contact.purpose
                            Definition

                            Indicates a purpose for which the contact can be reached.

                            ShortThe type of contact
                            Control0..1
                            BindingUnless not suitable, these codes SHALL be taken from ContactEntityType
                            (extensible to http://hl7.org/fhir/ValueSet/contactentity-type)

                            The purpose for which you would contact a contact party.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summaryfalse
                            Requirements

                            Need to distinguish between multiple contact persons.

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

                            A name associated with the contact.

                            ShortA name associated with the contact
                            Control0..1
                            TypeHumanName
                            Is Modifierfalse
                            Summaryfalse
                            Requirements

                            Need to be able to track the person by name.

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

                            A contact detail (e.g. a telephone number or an email address) by which the party may be contacted.

                            ShortContact details (telephone, email, etc.) for a contact
                            Control0..*
                            TypeContactPoint
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Requirements

                            People have (primary) ways to contact them in some way such as phone, email.

                            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 Organization.contact.telecom. The slices are unordered and Open, and can be differentiated using the following discriminators:
                            • value @ system
                            • 148. Organization.contact.telecom:phone
                              Slice Namephone
                              Definition

                              A contact detail (e.g. a telephone number or an email address) by which the party may be contacted.

                              ShortContact details (telephone, email, etc.) for a contact
                              Control0..*
                              TypeContactPoint
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              People have (primary) ways to contact them in some way such as phone, email.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              150. Organization.contact.telecom:phone.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
                              152. Organization.contact.telecom:phone.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 Organization.contact.telecom.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 154. Organization.contact.telecom:phone.system
                                Definition

                                Telecommunications form for contact point - what communications system is required to make use of the contact.

                                Shortphone | fax | email | pager | url | sms | other
                                Control0..1
                                This element is affected by the following invariants: cpt-2
                                BindingThe codes SHALL be taken from ContactPointSystem
                                (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

                                Telecommunications form for contact point.

                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Fixed Valuephone
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                156. Organization.contact.telecom:phone.value
                                Definition

                                The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

                                ShortThe actual contact point details
                                Comments

                                Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

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

                                Need to support legacy numbers that are not in a tightly controlled format.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                158. Organization.contact.telecom:phone.use
                                Definition

                                Identifies the purpose for the contact point.

                                Shorthome | work | temp | old | mobile - purpose of this contact point
                                Comments

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

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

                                Use of contact point.

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

                                Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                160. Organization.contact.telecom:phone.rank
                                Definition

                                Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

                                ShortSpecify preferred order of use (1 = highest)
                                Comments

                                Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

                                Control0..1
                                TypepositiveInt
                                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()))
                                162. Organization.contact.telecom:phone.period
                                Definition

                                Time period when the contact point was/is in use.

                                ShortTime period when the contact point was/is in use
                                Control0..1
                                TypePeriod
                                Is Modifierfalse
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                164. Organization.contact.telecom:email
                                Slice Nameemail
                                Definition

                                A contact detail (e.g. a telephone number or an email address) by which the party may be contacted.

                                ShortContact details (telephone, email, etc.) for a contact
                                Control0..1
                                TypeContactPoint
                                Is Modifierfalse
                                Must Supporttrue
                                Summaryfalse
                                Requirements

                                People have (primary) ways to contact them in some way such as phone, email.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                166. Organization.contact.telecom:email.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
                                168. Organization.contact.telecom:email.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 Organization.contact.telecom.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 170. Organization.contact.telecom:email.system
                                  Definition

                                  Telecommunications form for contact point - what communications system is required to make use of the contact.

                                  Shortphone | fax | email | pager | url | sms | other
                                  Control0..1
                                  This element is affected by the following invariants: cpt-2
                                  BindingThe codes SHALL be taken from ContactPointSystem
                                  (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

                                  Telecommunications form for contact point.

                                  Typecode
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Fixed Valueemail
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  172. Organization.contact.telecom:email.value
                                  Definition

                                  The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

                                  ShortThe actual contact point details
                                  Comments

                                  Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

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

                                  Need to support legacy numbers that are not in a tightly controlled format.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  174. Organization.contact.telecom:email.use
                                  Definition

                                  Identifies the purpose for the contact point.

                                  Shorthome | work | temp | old | mobile - purpose of this contact point
                                  Comments

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

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

                                  Use of contact point.

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

                                  Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  176. Organization.contact.telecom:email.rank
                                  Definition

                                  Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

                                  ShortSpecify preferred order of use (1 = highest)
                                  Comments

                                  Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

                                  Control0..1
                                  TypepositiveInt
                                  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()))
                                  178. Organization.contact.telecom:email.period
                                  Definition

                                  Time period when the contact point was/is in use.

                                  ShortTime period when the contact point was/is in use
                                  Control0..1
                                  TypePeriod
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  180. Organization.contact.address
                                  Definition

                                  Visiting or postal addresses for the contact.

                                  ShortVisiting or postal addresses for the contact
                                  Control0..1
                                  TypeAddress
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  Requirements

                                  May need to keep track of a contact party's address for contacting, billing or reporting requirements.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  182. Organization.contact.address.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
                                  184. Organization.contact.address.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 Organization.contact.address.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 186. Organization.contact.address.use
                                    Definition

                                    The purpose of this address.

                                    Shorthome | work | temp | old | billing - purpose of this address
                                    Comments

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

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

                                    The use of an address.

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

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

                                    Example<br/><b>General</b>:home
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    188. Organization.contact.address.type
                                    Definition

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

                                    Shortpostal | physical | both
                                    Comments

                                    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).

                                    Control0..1
                                    BindingThe codes SHALL be taken from AddressType
                                    (required to http://hl7.org/fhir/ValueSet/address-type|4.0.1)

                                    The type of an address (physical / postal).

                                    Typecode
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Example<br/><b>General</b>:both
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    190. Organization.contact.address.text
                                    Definition

                                    Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

                                    ShortText representation of the address
                                    Comments

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

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

                                    A renderable, unencoded form.

                                    Example<br/><b>General</b>:137 Nowhere Street, Erewhon 9132
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    192. Organization.contact.address.line
                                    Definition

                                    This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

                                    ShortStreet name, number, direction & P.O. Box etc.
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summarytrue
                                    Example<br/><b>General</b>:137 Nowhere Street
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    194. Organization.contact.address.city
                                    Definition

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

                                    ShortName of city, town etc.
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Alternate NamesMunicpality
                                    Example<br/><b>General</b>:Erewhon
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    196. Organization.contact.address.district
                                    Definition

                                    The name of the administrative area (county).

                                    ShortDistrict name (aka county)
                                    Comments

                                    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.

                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Alternate NamesCounty
                                    Example<br/><b>General</b>:Madison
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    198. Organization.contact.address.state
                                    Definition

                                    Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

                                    ShortSub-unit of country (abbreviations ok)
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Alternate NamesProvince, Territory
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    200. Organization.contact.address.postalCode
                                    Definition

                                    A postal code designating a region defined by the postal service.

                                    ShortPostal code for area
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Alternate NamesZip
                                    Example<br/><b>General</b>:9132
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    202. Organization.contact.address.country
                                    Definition

                                    Country - a nation as commonly understood or generally accepted.

                                    ShortCountry (e.g. can be ISO 3166 2 or 3 letter code)
                                    Comments

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

                                    Control0..1
                                    Typestring
                                    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()))
                                    204. Organization.contact.address.period
                                    Definition

                                    Time period when address was/is in use.

                                    ShortTime period when address was/is in use
                                    Control0..1
                                    TypePeriod
                                    Is Modifierfalse
                                    Summarytrue
                                    Requirements

                                    Allows addresses to be placed in historical context.

                                    Example<br/><b>General</b>:{ "start" : "2010-03-23", "end" : "2010-07-01" }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    206. Organization.endpoint
                                    Definition

                                    Technical endpoints providing access to services operated for the organization.

                                    ShortTechnical endpoints providing access to services operated for the organization
                                    Control0..*
                                    TypeReference(eHx Endpoint)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Requirements

                                    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.

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