FHIR Implementation Guide for ABDM
6.5.0 - active
FHIR Implementation Guide for ABDM
6.5.0 - active
This page is part of the FHIR Implementation Guide for ABDM (v6.5.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions
| Official URL: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Communication | Version: 6.5.0 | |||
| Draft as of 2025-03-18 | Computable Name: Communication | |||
This profile sets the minimum requirement for documenting any communication, whether it is planned or unsuccessful. A communication refers to the exchange of information from a sender to a receiver, and these entities can encompass patients, practitioners, related individuals, organizations, or devices. The resource serves as a record of these interactions.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Communication |
0..* | Communication | A record of information transmitted from a sender to a receiver dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management | |
  implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children |
 modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
 inResponseTo |
0..* | Reference(Communication) | Reply to ele-1: All FHIR elements must have a @value or children | |
| status |
?!Σ | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): The status of the communication. ele-1: All FHIR elements must have a @value or children |
| subject |
Σ | 0..1 | Reference(Group | Patient) | Focus of message ele-1: All FHIR elements must have a @value or children |
| encounter |
Σ | 0..1 | Reference(Encounter) | Encounter created as part of ele-1: All FHIR elements must have a @value or children |
| recipient |
0..* | Reference(Device | RelatedPerson | Group | CareTeam | HealthcareService | Organization | Patient | Practitioner | PractitionerRole) | Message recipient ele-1: All FHIR elements must have a @value or children | |
| sender |
0..1 | Reference(Device | RelatedPerson | HealthcareService | Practitioner | PractitionerRole | Organization | Patient) | Message sender ele-1: All FHIR elements must have a @value or children | |
 reasonReference |
Σ | 0..* | Reference(DiagnosticReport | Condition | Observation | DocumentReference) | Why was communication done? ele-1: All FHIR elements must have a @value or children |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| Communication.status | required | EventStatushttp://hl7.org/fhir/ValueSet/event-status|4.0.1from the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | Communication | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | Communication | 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 | error | Communication | 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 | error | Communication | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Communication | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
This structure is derived from Communication
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Communication |
0..* | Communication | A record of information transmitted from a sender to a receiver | |
| inResponseTo |
0..* | Reference(Communication) | Reply to | |
| subject |
0..1 | Reference(Group | Patient) | Focus of message | |
| encounter |
0..1 | Reference(Encounter) | Encounter created as part of | |
| recipient |
0..* | Reference(Device | RelatedPerson | Group | CareTeam | HealthcareService | Organization | Patient | Practitioner | PractitionerRole) | Message recipient | |
| sender |
0..1 | Reference(Device | RelatedPerson | HealthcareService | Practitioner | PractitionerRole | Organization | Patient) | Message sender | |
| reasonReference |
0..* | Reference(DiagnosticReport | Condition | Observation | DocumentReference) | Why was communication done? | |
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| Communication |
0..* | Communication | A record of information transmitted from a sender to a receiver | |||||
| id |
Σ | 0..1 | id | Logical id of this artifact | ||||
 meta |
Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
 extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| identifier |
Σ | 0..* | Identifier | Unique identifier | ||||
| instantiatesCanonical |
Σ | 0..* | canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire) | Instantiates FHIR protocol or definition | ||||
| instantiatesUri |
Σ | 0..* | uri | Instantiates external protocol or definition | ||||
| basedOn |
Σ | 0..* | Reference(Resource) | Request fulfilled by this communication | ||||
| partOf |
Σ | 0..* | Reference(Resource) | Part of this action | ||||
| inResponseTo |
0..* | Reference(Communication) | Reply to | |||||
| status |
?!Σ | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): The status of the communication. | ||||
| statusReason |
Σ | 0..1 | CodeableConcept | Reason for current status Binding: CommunicationNotDoneReason (example): Codes for the reason why a communication did not happen. | ||||
| category |
0..* | CodeableConcept | Message category Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc. | |||||
| priority |
Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Codes indicating the relative importance of a communication. | ||||
| medium |
0..* | CodeableConcept | A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc. | |||||
| subject |
Σ | 0..1 | Reference(Group | Patient) | Focus of message | ||||
| topic |
0..1 | CodeableConcept | Description of the purpose/content Binding: CommunicationTopic (example): Codes describing the purpose or content of the communication. | |||||
| about |
0..* | Reference(Resource) | Resources that pertain to this communication | |||||
| encounter |
Σ | 0..1 | Reference(Encounter) | Encounter created as part of | ||||
| sent |
0..1 | dateTime | When sent | |||||
| received |
0..1 | dateTime | When received | |||||
| recipient |
0..* | Reference(Device | RelatedPerson | Group | CareTeam | HealthcareService | Organization | Patient | Practitioner | PractitionerRole) | Message recipient | |||||
| sender |
0..1 | Reference(Device | RelatedPerson | HealthcareService | Practitioner | PractitionerRole | Organization | Patient) | Message sender | |||||
| reasonCode |
Σ | 0..* | CodeableConcept | Indication for message Binding: SNOMEDCTClinicalFindings (example): Codes for describing reasons for the occurrence of a communication. | ||||
| reasonReference |
Σ | 0..* | Reference(DiagnosticReport | Condition | Observation | DocumentReference) | Why was communication done? | ||||
 payload |
0..* | BackboneElement | Message payload | |||||
 id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
  content[x] |
1..1 | Message part content | ||||||
 contentString |
string | |||||||
| contentAttachment |
Attachment | |||||||
| contentReference |
Reference(Resource) | |||||||
| note |
0..* | Annotation | Comments made about the communication | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet | URI | |||
| Communication.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard
| ||||
| Communication.status | required | EventStatushttp://hl7.org/fhir/ValueSet/event-status|4.0.1from the FHIR Standard | ||||
| Communication.statusReason | example | CommunicationNotDoneReasonhttp://hl7.org/fhir/ValueSet/communication-not-done-reasonfrom the FHIR Standard | ||||
| Communication.category | example | CommunicationCategoryhttp://hl7.org/fhir/ValueSet/communication-categoryfrom the FHIR Standard | ||||
| Communication.priority | required | RequestPriorityhttp://hl7.org/fhir/ValueSet/request-priority|4.0.1from the FHIR Standard | ||||
| Communication.medium | example | ParticipationModehttp://terminology.hl7.org/ValueSet/v3-ParticipationMode | ||||
| Communication.topic | example | CommunicationTopichttp://hl7.org/fhir/ValueSet/communication-topicfrom the FHIR Standard | ||||
| Communication.reasonCode | example | SNOMEDCTClinicalFindingshttp://hl7.org/fhir/ValueSet/clinical-findingsfrom the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | Communication | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | Communication | 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 | error | Communication | 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 | error | Communication | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Communication | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
This structure is derived from Communication
Summary
Structures
This structure refers to these other structures:
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Communication |
0..* | Communication | A record of information transmitted from a sender to a receiver dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management | |
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children |
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
| inResponseTo |
0..* | Reference(Communication) | Reply to ele-1: All FHIR elements must have a @value or children | |
| status |
?!Σ | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): The status of the communication. ele-1: All FHIR elements must have a @value or children |
| subject |
Σ | 0..1 | Reference(Group | Patient) | Focus of message ele-1: All FHIR elements must have a @value or children |
| encounter |
Σ | 0..1 | Reference(Encounter) | Encounter created as part of ele-1: All FHIR elements must have a @value or children |
| recipient |
0..* | Reference(Device | RelatedPerson | Group | CareTeam | HealthcareService | Organization | Patient | Practitioner | PractitionerRole) | Message recipient ele-1: All FHIR elements must have a @value or children | |
| sender |
0..1 | Reference(Device | RelatedPerson | HealthcareService | Practitioner | PractitionerRole | Organization | Patient) | Message sender ele-1: All FHIR elements must have a @value or children | |
| reasonReference |
Σ | 0..* | Reference(DiagnosticReport | Condition | Observation | DocumentReference) | Why was communication done? ele-1: All FHIR elements must have a @value or children |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| Communication.status | required | EventStatushttp://hl7.org/fhir/ValueSet/event-status|4.0.1from the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | Communication | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | Communication | 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 | error | Communication | 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 | error | Communication | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Communication | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
Differential View
This structure is derived from Communication
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Communication |
0..* | Communication | A record of information transmitted from a sender to a receiver | |
| inResponseTo |
0..* | Reference(Communication) | Reply to | |
| subject |
0..1 | Reference(Group | Patient) | Focus of message | |
| encounter |
0..1 | Reference(Encounter) | Encounter created as part of | |
| recipient |
0..* | Reference(Device | RelatedPerson | Group | CareTeam | HealthcareService | Organization | Patient | Practitioner | PractitionerRole) | Message recipient | |
| sender |
0..1 | Reference(Device | RelatedPerson | HealthcareService | Practitioner | PractitionerRole | Organization | Patient) | Message sender | |
| reasonReference |
0..* | Reference(DiagnosticReport | Condition | Observation | DocumentReference) | Why was communication done? | |
| Documentation for this format | ||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| Communication |
0..* | Communication | A record of information transmitted from a sender to a receiver | |||||
| id |
Σ | 0..1 | id | Logical id of this artifact | ||||
| meta |
Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| identifier |
Σ | 0..* | Identifier | Unique identifier | ||||
| instantiatesCanonical |
Σ | 0..* | canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire) | Instantiates FHIR protocol or definition | ||||
| instantiatesUri |
Σ | 0..* | uri | Instantiates external protocol or definition | ||||
| basedOn |
Σ | 0..* | Reference(Resource) | Request fulfilled by this communication | ||||
| partOf |
Σ | 0..* | Reference(Resource) | Part of this action | ||||
| inResponseTo |
0..* | Reference(Communication) | Reply to | |||||
| status |
?!Σ | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): The status of the communication. | ||||
| statusReason |
Σ | 0..1 | CodeableConcept | Reason for current status Binding: CommunicationNotDoneReason (example): Codes for the reason why a communication did not happen. | ||||
| category |
0..* | CodeableConcept | Message category Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc. | |||||
| priority |
Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Codes indicating the relative importance of a communication. | ||||
| medium |
0..* | CodeableConcept | A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc. | |||||
| subject |
Σ | 0..1 | Reference(Group | Patient) | Focus of message | ||||
| topic |
0..1 | CodeableConcept | Description of the purpose/content Binding: CommunicationTopic (example): Codes describing the purpose or content of the communication. | |||||
| about |
0..* | Reference(Resource) | Resources that pertain to this communication | |||||
| encounter |
Σ | 0..1 | Reference(Encounter) | Encounter created as part of | ||||
| sent |
0..1 | dateTime | When sent | |||||
| received |
0..1 | dateTime | When received | |||||
| recipient |
0..* | Reference(Device | RelatedPerson | Group | CareTeam | HealthcareService | Organization | Patient | Practitioner | PractitionerRole) | Message recipient | |||||
| sender |
0..1 | Reference(Device | RelatedPerson | HealthcareService | Practitioner | PractitionerRole | Organization | Patient) | Message sender | |||||
| reasonCode |
Σ | 0..* | CodeableConcept | Indication for message Binding: SNOMEDCTClinicalFindings (example): Codes for describing reasons for the occurrence of a communication. | ||||
| reasonReference |
Σ | 0..* | Reference(DiagnosticReport | Condition | Observation | DocumentReference) | Why was communication done? | ||||
| payload |
0..* | BackboneElement | Message payload | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| content[x] |
1..1 | Message part content | ||||||
| contentString |
string | |||||||
| contentAttachment |
Attachment | |||||||
| contentReference |
Reference(Resource) | |||||||
| note |
0..* | Annotation | Comments made about the communication | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet | URI | |||
| Communication.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard
| ||||
| Communication.status | required | EventStatushttp://hl7.org/fhir/ValueSet/event-status|4.0.1from the FHIR Standard | ||||
| Communication.statusReason | example | CommunicationNotDoneReasonhttp://hl7.org/fhir/ValueSet/communication-not-done-reasonfrom the FHIR Standard | ||||
| Communication.category | example | CommunicationCategoryhttp://hl7.org/fhir/ValueSet/communication-categoryfrom the FHIR Standard | ||||
| Communication.priority | required | RequestPriorityhttp://hl7.org/fhir/ValueSet/request-priority|4.0.1from the FHIR Standard | ||||
| Communication.medium | example | ParticipationModehttp://terminology.hl7.org/ValueSet/v3-ParticipationMode | ||||
| Communication.topic | example | CommunicationTopichttp://hl7.org/fhir/ValueSet/communication-topicfrom the FHIR Standard | ||||
| Communication.reasonCode | example | SNOMEDCTClinicalFindingshttp://hl7.org/fhir/ValueSet/clinical-findingsfrom the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | Communication | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | Communication | 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 | error | Communication | 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 | error | Communication | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Communication | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
This structure is derived from Communication
Summary
Structures
This structure refers to these other structures:
Other representations of profile: CSV, Excel, Schematron