ZD Consent
Resources conforming to this profile are requested by ZorgDomein when SSO has succeeded and patient details are fetched from the source system.
Queries on the https://[FHIRServerUrl]/Consent endpoint may include the following query parameters:
patient=[PatientID]:[PatientID]refers to the patient ID as provided in the Task resource that is requested by ZorgDomein during SSO.category=[CodedCategory]: the following categories are used:urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.14.1|NR– Resuscitation policy (reanimatiebeleid).urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.14.1|VOL– Advance directive (levenstestament).urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.14.1|DO– Donorcodicil (donorcodicil)._sort=-date: indicates that the resources in the search result must be sorted by date, descending._count=1: return only 1 resource in the search result.
The canonical URL for this profile is:
http://zorgdomein.nl/fhir/StructureDefinition/zd-consent
This profile builds on Consent.
| Consent | S | 0..* | Consent | Element IdConsent A healthcare consumer's policy choices to permits or denies recipients or roles to perform actions for specific purposes and periods of time DefinitionA record of a healthcare consumer’s policy choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time. Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives.
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| text | S | 1..1 | Narrative | Element IdConsent.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
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| identifier | Σ | 0..1 | Identifier | Element IdConsent.identifier Identifier for this record (external references) DefinitionUnique identifier for this copy of the Consent Statement. This identifier is identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same.
General {
"system": "urn:ietf:rfc:3986",
"value": "Local eCMS identifier"
}Mappings
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| status | Σ ?! | 1..1 | codeBinding | Element IdConsent.status draft | proposed | active | rejected | inactive | entered-in-error DefinitionIndicates the current state of this consent. The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive. This element is labeled as a modifier because the status contains the codes rejected and entered-in-error that mark the Consent as not currently valid.
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| category | Σ | 1..* | CodeableConcept | Element IdConsent.category Classification of the consent statement - for indexing/retrieval DefinitionA classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Unordered, Open, by coding.system(Value) BindingConsent Category Codes (example) Constraints
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| typeOfLivingWill | Σ | 1..1 | CodeableConceptBinding | Element IdConsent.category:typeOfLivingWill Classification of the consent statement - for indexing/retrieval DefinitionA classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.15.1--20171231000000 (extensible) Constraints
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| coding | Σ | 1..1 | Coding | Element IdConsent.category:typeOfLivingWill.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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| system | Σ | 1..1 | uri | Element IdConsent.category:typeOfLivingWill.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
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| version | Σ | 0..1 | string | Element IdConsent.category:typeOfLivingWill.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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| code | Σ | 1..1 | code | Element IdConsent.category:typeOfLivingWill.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings may not exceed 1MB in size
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| display | Σ | 0..1 | string | Element IdConsent.category:typeOfLivingWill.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings may not exceed 1MB in size
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| userSelected | Σ | 0..1 | boolean | Element IdConsent.category:typeOfLivingWill.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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| text | Σ | 0..1 | string | Element IdConsent.category:typeOfLivingWill.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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| patient | Σ | 1..1 | Reference(Patient) | Element IdConsent.patient Who the consent applies to DefinitionThe patient/healthcare consumer to whom this consent applies. Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person.
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| period | Σ | 0..1 | Period | Element IdConsent.period Period that this consent applies DefinitionRelevant time or time-period when this Consent is applicable. This can be a subset of the period of the original statement.
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| dateTime | Σ | 0..1 | dateTime | Element IdConsent.dateTime When this Consent was created or indexed DefinitionWhen this Consent was issued / created / indexed. This is not the time of the original consent, but the time that this statement was made or derived.
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| consentingParty | Σ | 0..* | Reference(Organization | Patient | Practitioner | RelatedPerson) | Element IdConsent.consentingParty Who is agreeing to the policy and exceptions Alternate namesconsentor DefinitionEither the Grantor, which is the entity responsible for granting the rights listed in a Consent Directive or the Grantee, which is the entity responsible for complying with the Consent Directive, including any obligations or limitations on authorizations and enforcement of prohibitions. Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian. Reference(Organization | Patient | Practitioner | RelatedPerson) Constraints
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| actor | Σ | 0..* | BackboneElement | Element IdConsent.actor Who|what controlled by this consent (or group, by role) DefinitionWho or what is controlled by this consent. Use group to identify a set of actors by some property they share (e.g. 'admitting officers').
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| role | 1..1 | CodeableConceptBinding | Element IdConsent.actor.role How the actor is involved DefinitionHow the individual is involved in the resources content that is described in the consent. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
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| reference | 1..1 | Reference(Device | Group | CareTeam | Organization | Patient | Practitioner | RelatedPerson) | Element IdConsent.actor.reference Resource for the actor (or group, by role) DefinitionThe resource that identifies the actor. To identify a actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers'). References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Device | Group | CareTeam | Organization | Patient | Practitioner | RelatedPerson) Constraints
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| action | Σ | 0..* | CodeableConcept | Element IdConsent.action Actions controlled by this consent DefinitionActions controlled by this consent. Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'. Consent Action Codes (example) Constraints
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| organization | Σ | 0..* | Reference(Organization) | Element IdConsent.organization Custodian of the consent Alternate namescustodian DefinitionThe organization that manages the consent, and the framework within which it is executed. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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| source[x] | Σ | 0..1 | Element IdConsent.source[x] Source from which this consent is taken DefinitionThe source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document. The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id.
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| sourceAttachment | Attachment | Data Type | ||
| sourceIdentifier | Identifier | Data Type | ||
| sourceReference | Reference(Consent | DocumentReference | Contract | QuestionnaireResponse) | Data Type Reference(Consent | DocumentReference | Contract | QuestionnaireResponse) | ||
| policy | 0..* | BackboneElement | Element IdConsent.policy Policies covered by this consent DefinitionThe references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law.
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| authority | 0..1 | uri | Element IdConsent.policy.authority Enforcement source for policy DefinitionEntity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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| uri | 0..1 | uri | Element IdConsent.policy.uri Specific policy covered by this consent DefinitionThe references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. This element is for discoverability / documentation, and does not modify or qualify the policy rules.
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| policyRule | Σ | 0..1 | uri | Element IdConsent.policyRule Policy that this consents to DefinitionA referece to the specific computable policy. Might be a unique identifier of a policy set in XACML, or other rules engine. If the policy reference is not known, the resource cannot be processed. Where the reference is absent, there is no particular policy other than what is expressed directly in the consent resource.
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| securityLabel | Σ | 0..* | CodingBinding | Element IdConsent.securityLabel Security Labels that define affected resources DefinitionA set of security labels that define which resources are controlled by this consent. If more than one label is specified, all resources must have all the specified labels. If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. Not all of the security labels make sense for use in this element (may define a narrower value set?). All Security Labels (extensible) Constraints
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| purpose | Σ | 0..* | CodingBinding | Element IdConsent.purpose Context of activities for which the agreement is made DefinitionThe context of the activities a user is taking - why the user is accessing the data - that are controlled by this consent. This element is for discoverability / documentation, and does not modify or qualify the policy (e.g. the policy itself describes the purposes for which it applies).
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| dataPeriod | Σ | 0..1 | Period | Element IdConsent.dataPeriod Timeframe for data controlled by this consent DefinitionClinical or Operational Relevant period of time that bounds the data controlled by this consent. This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement.
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| data | Σ | 0..* | BackboneElement | Element IdConsent.data Data controlled by this consent DefinitionThe resources controlled by this consent, if specific resources are referenced.
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| meaning | Σ | 1..1 | codeBinding | Element IdConsent.data.meaning instance | related | dependents | authoredby DefinitionHow the resource reference is interpreted when testing consent restrictions. Note that FHIR strings may not exceed 1MB in size
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| reference | Σ | 1..1 | Reference(Resource) | Element IdConsent.data.reference The actual data reference DefinitionA reference to a specific resource that defines which resources are covered by this consent. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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| except | Σ | 0..* | BackboneElement | Element IdConsent.except Additional rule - addition or removal of permissions DefinitionAn exception to the base policy of this consent. An exception can be an addition or removal of access permissions.
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| type | Σ | 1..1 | codeBinding | Element IdConsent.except.type deny | permit DefinitionAction to take - permit or deny - when the exception conditions are met. Note that FHIR strings may not exceed 1MB in size
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| period | Σ | 0..1 | Period | Element IdConsent.except.period Timeframe for this exception DefinitionThe timeframe in this exception is valid. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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| actor | Σ | 0..* | BackboneElement | Element IdConsent.except.actor Who|what controlled by this exception (or group, by role) DefinitionWho or what is controlled by this Exception. Use group to identify a set of actors by some property they share (e.g. 'admitting officers').
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| role | 1..1 | CodeableConceptBinding | Element IdConsent.except.actor.role How the actor is involved DefinitionHow the individual is involved in the resources content that is described in the exception. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
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| reference | 1..1 | Reference(Device | Group | CareTeam | Organization | Patient | Practitioner | RelatedPerson) | Element IdConsent.except.actor.reference Resource for the actor (or group, by role) DefinitionThe resource that identifies the actor. To identify a actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers'). References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Device | Group | CareTeam | Organization | Patient | Practitioner | RelatedPerson) Constraints
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| action | Σ | 0..* | CodeableConcept | Element IdConsent.except.action Actions controlled by this exception DefinitionActions controlled by this Exception. Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'. Consent Action Codes (example) Constraints
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| securityLabel | Σ | 0..* | CodingBinding | Element IdConsent.except.securityLabel Security Labels that define affected resources DefinitionA set of security labels that define which resources are controlled by this exception. If more than one label is specified, all resources must have all the specified labels. If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. Not all of the security labels make sense for use in this element (may define a narrower value set?). All Security Labels (extensible) Constraints
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| purpose | Σ | 0..* | CodingBinding | Element IdConsent.except.purpose Context of activities covered by this exception DefinitionThe context of the activities a user is taking - why the user is accessing the data - that are controlled by this exception. E.g. if the purpose is 'research', then the operational context must be research, in order for the consent to apply. Not all of the security labels make sense for use in this element (may define a narrower value set?).
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| class | Σ | 0..* | CodingBinding | Element IdConsent.except.class e.g. Resource Type, Profile, or CDA etc DefinitionThe class of information covered by this exception. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to. Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere. Consent Content Class (extensible) Constraints
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| code | Σ | 0..* | Coding | Element IdConsent.except.code e.g. LOINC or SNOMED CT code, etc in the content DefinitionIf this code is found in an instance, then the exception applies. Typical use of this is a Document code with class = CDA. Consent Content Codes (example) Constraints
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| dataPeriod | Σ | 0..1 | Period | Element IdConsent.except.dataPeriod Timeframe for data controlled by this exception DefinitionClinical or Operational Relevant period of time that bounds the data controlled by this exception. This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement.
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| data | Σ | 0..* | BackboneElement | Element IdConsent.except.data Data controlled by this exception DefinitionThe resources controlled by this exception, if specific resources are referenced.
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| meaning | Σ | 1..1 | codeBinding | Element IdConsent.except.data.meaning instance | related | dependents | authoredby DefinitionHow the resource reference is interpreted when testing consent restrictions. Note that FHIR strings may not exceed 1MB in size
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| reference | Σ | 1..1 | Reference(Resource) | Element IdConsent.except.data.reference The actual data reference DefinitionA reference to a specific resource that defines which resources are covered by this consent. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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See the profile on simplifier.net for additional details.
Resource example
Below you find an example of a resource that conforms to the ZD Consent profile.
{
"resourceType": "Consent",
"id": "258",
"meta": {
"lastUpdated": "2021-02-09T10:12:04.374+01:00"
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Niet reanimeren verklaring</div>"
},
"status": "active",
"category": [
{
"coding": [
{
"system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.14.1",
"code": "NR",
"display": "Reanimatiebeleid"
}
]
}
],
"patient": {
"reference": "Patient/1"
},
"policy": [
{
"uri": "http://wetten.overheid.nl/"
}
]
}
<Consent xmlns='http://hl7.org/fhir'>
<id value='258'/>
<meta>
<lastUpdated value='2021-02-09T10:12:04.374+01:00'/>
</meta>
<text>
<status value='generated'/>
<div xmlns='http://www.w3.org/1999/xhtml'>Niet reanimeren verklaring</div>
</text>
<status value='active'/>
<category>
<coding>
<system value='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.14.1'/>
<code value='NR'/>
<display value='Reanimatiebeleid'/>
</coding>
</category>
<patient>
<reference value='Patient/1'/>
</patient>
<policy>
<uri value='http://wetten.overheid.nl/'/>
</policy>
</Consent>