Netherlands - Generic Functions for data exchange Implementation Guide
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Resource Profile: NlGfPractitioner - Detailed Descriptions

Draft as of 2026-03-24

Definitions for the nl-gf-practitioner resource profile.

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

0. Practitioner
Definition

A health professional is a person who is authorized to perform actions in the field of individual healthcare.


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

ShortHealthProfessionalA person with a formal responsibility in the provisioning of healthcare or related services
Comments

The zib HealthProfessional is mapped for all but one concept (HealthProfessionalRole) to this Practitioner profile and a profile on PractitionerRole (http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole). The PractitionerRole resource covers the recording of the location and types of services that HealthProfessionals are able to provide for a HealthcareProvider. The zib concepts Specialty and HealthcareProvider are therefore mapped onto PractitionerRole.

Although the zib concept name HealthProfessionalRole superficially seems to match the PractitionerRole resource, this is not the case based on the definition and values of that concept. In FHIR, the role that a HealthProfessional fulfills is captured as part of the clinical resource for that specific case, for example in the Procedure.performer.role element. This prevents the creation of duplicate HealthProfessional instances for each clinical situation where the HealthProfessional performs a different role in the process.

Control0..*
Is Modifierfalse
Complies with ProfileThis profile complies with the profile
Summaryfalse
Alternate NamesZorgverlener, nl-core-HealthProfessional-Practitioner
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Practitioner.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..01
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. Practitioner.modifierExtension
Definition

An Extension


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).

ShortExtensionExtensions 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..0*
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())
6. Practitioner.identifier
Definition

The healthcare provider identification number is a number that uniquely identifies the healthcare provider.

The following numbers are used in the Netherlands:

  1. UZI Health Professionals. Identification of health professionals (people) in the Dutch healthcare industry.
  2. VEKTIS AGB-Z. Identifies health professionals and healthcare organizations
  3. BIG-ID. The ID of the health professional listed in the BIG Register.

This information is not readily available for foreign health professionals.


An identifier that applies to this person in this role.

ShortHealthProfessionalIdentificationNumberAn identifier for the person as this agent
NoteThis is a business identifier, not a resource identifier (see discussion)
Control10..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Requirements

Often, specific identities are assigned for the agent.

Alternate NamesZorgverlenerIdentificatienummer
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Practitioner.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ $this
  • profile @ $this
  • 8. Practitioner.identifier:big
    Slice Namebig
    Definition

    An identifier that applies to this person in this role.

    ShortAn identifier for the person as this agent
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    TypeIdentifier
    Is Modifierfalse
    Summarytrue
    Requirements

    Often, specific identities are assigned for the agent.

    Pattern Value{
      "system" : "http://fhir.nl/fhir/NamingSystem/big"
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. Practitioner.identifier:uzi
    Slice Nameuzi
    Definition

    An identifier that applies to this person in this role.

    ShortAn identifier for the person as this agent
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    TypeIdentifier
    Is Modifierfalse
    Summarytrue
    Requirements

    Often, specific identities are assigned for the agent.

    Pattern Value{
      "system" : "http://fhir.nl/fhir/NamingSystem/uzi-nr-pers"
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. Practitioner.identifier:agb
    Slice Nameagb
    Definition

    An identifier that applies to this person in this role.

    ShortAn identifier for the person as this agent
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    TypeIdentifier
    Is Modifierfalse
    Summarytrue
    Requirements

    Often, specific identities are assigned for the agent.

    Pattern Value{
      "system" : "http://fhir.nl/fhir/NamingSystem/agb-z"
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. Practitioner.identifier:AssignedId
    Slice NameAssignedId
    Definition

    The healthcare provider identification number is a number that uniquely identifies the healthcare provider.

    The following numbers are used in the Netherlands:

    1. UZI Health Professionals. Identification of health professionals (people) in the Dutch healthcare industry.
    2. VEKTIS AGB-Z. Identifies health professionals and healthcare organizations
    3. BIG-ID. The ID of the health professional listed in the BIG Register.

    This information is not readily available for foreign health professionals.


    An identifier that applies to this person in this role.

    ShortHealthProfessionalIdentificationNumberAn identifier for the person as this agent
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control10..1*
    TypeIdentifier(Custodian Assigned Identifier)
    Is Modifierfalse
    Summarytrue
    Requirements

    Often, specific identities are assigned for the agent.

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

    Health professional’s full name. If a health professional identification number is entered, it will be the name as listed in UZI, AGB or by the healthcare center.


    The name(s) associated with the practitioner.

    ShortNameInformationThe name(s) associated with the practitioner
    Comments

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

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

    1. There is more than 1 name
    2. Use = usual
    3. Period is current to the date of the usage
    4. Use = official
    5. Other order as decided by internal business rules.
    Control10..*
    TypeHumanName
    Is Modifierfalse
    Summarytrue
    Requirements

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

    Alternate NamesNaamgegevens
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on Practitioner.name. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ use
    • 18. Practitioner.name:nameInformation
      Slice NamenameInformation
      Definition

      This slice represents the person's official name information, including given names, last name and possibly the partner's last name.


      The name(s) associated with the practitioner.

      ShortNameInformationThe name(s) associated with the practitioner
      Comments

      This .name element accomodates the official parts of a Dutch name according to common international usage and optionally to the zib NameInformation v1.1 (2020). An official Dutch name is represented in FHIR as an ordinary international name, optionally augmented using extensions to specify how the last name is built up according to the Dutch rules if conformance to the zib is required. See the guidance on .family and on .extension:nameUsage for more information.

      Systems that need to work in a Dutch context SHOULD support the extensions as specified in .given, .family and .extension:nameUsage. In addition, systems SHOULD use the core elements according to the FHIR specifications to provide compatibility outside Dutch contexts. This means that:

      • If parts of the name are specified using one or more of the structured elements, the .text element SHOULD be populated with a rendered version of the full name.
      • If parts of the family name are specified using the extensions in .family, the .family element SHOULD be populated with the full family name.

      Note 1: The zib cannot be represented straightforward in FHIR. Especially note the guidance on .given on how to map the FirstNames and Initials concepts, and on .prefix/.suffix on how to map the Titles concept.

      Note 2: This element should only contain a person's official names. The GivenName concept is represented in another .name element with .name.use = usual.

      Note 3: The examples illustrate how the zib is mapped to FHIR.


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

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

      1. There is more than 1 name
      2. Use = usual
      3. Period is current to the date of the usage
      4. Use = official
      5. Other order as decided by internal business rules.
      Control0..2*
      This element is affected by the following invariants: ele-1
      TypeHumanName(nl core NameInformation)
      Is Modifierfalse
      Standard StatusNormative (from Trial Use)
      Summarytrue
      Requirements

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

      Alternate NamesNaamgegevens, nl-core-NameInformation
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      zib-NameInformation-1: If a prefix for a family name is specified, the family name is expected as well (family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not())
      zib-NameInformation-2: If the prefix for a partner family name is specified, the partner family name is expected as well (family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not())
      nl-core-NameInformation-01: If parts of the name are specified using one or more of the structured elements, the `.text` element SHOULD be populated with a rendered version of the full name. This ensures compatibility with common FHIR usage. ((family.exists() or given.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier').where(value != 'IN').exists()) implies text.hasValue())
      20. Practitioner.name:nameInformation-GivenName
      Slice NamenameInformation-GivenName
      Definition

      This slice represents the name information normally used to address the person.


      The name(s) associated with the practitioner.

      ShortName of a human - parts and usageThe name(s) associated with the practitioner
      Comments

      This .name element represents the Dutch given name ("roepnaam") according to the zib NameInformation v1.1 (2020).

      Note 1: This element should only contain a person's unofficial name. The official names are represented in one or more other .name elements with .name.use = official.

      Note 2: The examples illustrate how the zib is mapped to FHIR.


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

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

      1. There is more than 1 name
      2. Use = usual
      3. Period is current to the date of the usage
      4. Use = official
      5. Other order as decided by internal business rules.
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeHumanName(nl core NameInformation.GivenName)
      Is Modifierfalse
      Standard StatusNormative (from Trial Use)
      Summarytrue
      Requirements

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

      Alternate Namesnl-core-NameInformation.GivenName
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. Practitioner.telecom
      Definition

      Health professional’s telephone number(s) or e-mail address(es).


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

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

      The cardinality mismatch between the zib (0..1) and FHIR (0..*) is explained by the containers TelephoneNumbers (0..*) and EmailAddresses (0..*) inside the ContactInformation model. The FHIR datatype ContactPoint does not have these containers.


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

      Control0..*
      TypeContactPoint
      Is Modifierfalse
      Summarytrue
      Requirements

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

      Alternate NamesContactgegevens
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on Practitioner.telecom. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • profile @ $this
      • 24. Practitioner.telecom:telephoneNumbers
        Slice NametelephoneNumbers
        Definition

        Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.


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

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

        Implementation of the "TelephoneNumbers" concept of zib ContactInformation.

        Please note that, although the zib concepts TelecomType and NumberType are functionally equivalent to the FHIR concepts ContactPoint.system and ContactPoint.use respectively, a mismatch occurs on the concept of mobile phone numbers; the zib uses the first concept and FHIR the second. For this reason, the ValueSet on ContactPoint.system is too narrow and the zib code will need to be communicated using the ext-CodeSpecification extension.


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

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeContactPoint(nl core ContactInformation TelephoneNumbers)
        Is Modifierfalse
        Standard StatusNormative (from Trial Use)
        Summarytrue
        Requirements

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

        Alternate NamesTelefoonnummers, nl-core-ContactInformation-TelephoneNumbers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        cpt-2: A system is required if a value is provided. (value.empty() or system.exists())
        26. Practitioner.telecom:emailAddresses
        Slice NameemailAddresses
        Definition

        Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.


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

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

        Implementation of the "EmailAddresses" concept of zib ContactInformation.


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

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeContactPoint(nl core ContactInformation EmailAddresses)
        Is Modifierfalse
        Standard StatusNormative (from Trial Use)
        Summarytrue
        Requirements

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

        Alternate NamesEmailAdressen, nl-core-ContactInformation-EmailAddresses
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        cpt-2: A system is required if a value is provided. (value.empty() or system.exists())

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

        0. Practitioner
        Complies with ProfileThis profile complies with the profile
        2. Practitioner.implicitRules
        Control0..0
        4. Practitioner.modifierExtension
        Control0..0
        6. Practitioner.identifier
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control1..?
        SlicingThis element introduces a set of slices on Practitioner.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ $this
        • profile @ $this
        • 8. Practitioner.identifier:AssignedId
          Slice NameAssignedId
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control1..1
          TypeIdentifier(Custodian Assigned Identifier)
          10. Practitioner.name
          Control1..?

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

          0. Practitioner
          Definition

          A health professional is a person who is authorized to perform actions in the field of individual healthcare.

          ShortHealthProfessional
          Comments

          The zib HealthProfessional is mapped for all but one concept (HealthProfessionalRole) to this Practitioner profile and a profile on PractitionerRole (http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole). The PractitionerRole resource covers the recording of the location and types of services that HealthProfessionals are able to provide for a HealthcareProvider. The zib concepts Specialty and HealthcareProvider are therefore mapped onto PractitionerRole.

          Although the zib concept name HealthProfessionalRole superficially seems to match the PractitionerRole resource, this is not the case based on the definition and values of that concept. In FHIR, the role that a HealthProfessional fulfills is captured as part of the clinical resource for that specific case, for example in the Procedure.performer.role element. This prevents the creation of duplicate HealthProfessional instances for each clinical situation where the HealthProfessional performs a different role in the process.

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

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

          ShortLogical id of this artifact
          Comments

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

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

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

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

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

          ShortA set of rules under which this content was created
          Comments

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

          Control0..0
          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. Practitioner.language
          Definition

          The base language in which the resource is written.

          ShortLanguage of the resource content
          Comments

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

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

          A human language.

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

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

          ShortText summary of the resource, for human interpretation
          Comments

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

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

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

          ShortContained, inline Resources
          Comments

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

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

          May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

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

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          16. Practitioner.modifierExtension
          Definition

          An Extension

          ShortExtension
          Control0..0
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          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())
          18. Practitioner.identifier
          Definition

          The healthcare provider identification number is a number that uniquely identifies the healthcare provider.

          The following numbers are used in the Netherlands:

          1. UZI Health Professionals. Identification of health professionals (people) in the Dutch healthcare industry.
          2. VEKTIS AGB-Z. Identifies health professionals and healthcare organizations
          3. BIG-ID. The ID of the health professional listed in the BIG Register.

          This information is not readily available for foreign health professionals.

          ShortHealthProfessionalIdentificationNumber
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control1..*
          TypeIdentifier
          Is Modifierfalse
          Summarytrue
          Requirements

          Often, specific identities are assigned for the agent.

          Alternate NamesZorgverlenerIdentificatienummer
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on Practitioner.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ $this
          • profile @ $this
          • 20. Practitioner.identifier:big
            Slice Namebig
            Definition

            An identifier that applies to this person in this role.

            ShortAn identifier for the person as this agent
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier
            Is Modifierfalse
            Summarytrue
            Requirements

            Often, specific identities are assigned for the agent.

            Pattern Value{
              "system" : "http://fhir.nl/fhir/NamingSystem/big"
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            22. Practitioner.identifier:uzi
            Slice Nameuzi
            Definition

            An identifier that applies to this person in this role.

            ShortAn identifier for the person as this agent
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier
            Is Modifierfalse
            Summarytrue
            Requirements

            Often, specific identities are assigned for the agent.

            Pattern Value{
              "system" : "http://fhir.nl/fhir/NamingSystem/uzi-nr-pers"
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            24. Practitioner.identifier:agb
            Slice Nameagb
            Definition

            An identifier that applies to this person in this role.

            ShortAn identifier for the person as this agent
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier
            Is Modifierfalse
            Summarytrue
            Requirements

            Often, specific identities are assigned for the agent.

            Pattern Value{
              "system" : "http://fhir.nl/fhir/NamingSystem/agb-z"
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            26. Practitioner.identifier:AssignedId
            Slice NameAssignedId
            Definition

            The healthcare provider identification number is a number that uniquely identifies the healthcare provider.

            The following numbers are used in the Netherlands:

            1. UZI Health Professionals. Identification of health professionals (people) in the Dutch healthcare industry.
            2. VEKTIS AGB-Z. Identifies health professionals and healthcare organizations
            3. BIG-ID. The ID of the health professional listed in the BIG Register.

            This information is not readily available for foreign health professionals.

            ShortHealthProfessionalIdentificationNumber
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control1..1
            TypeIdentifier(Custodian Assigned Identifier)
            Is Modifierfalse
            Summarytrue
            Requirements

            Often, specific identities are assigned for the agent.

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

            Whether this practitioner's record is in active use.

            ShortWhether this practitioner's record is in active use
            Comments

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

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

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

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

            Health professional’s full name. If a health professional identification number is entered, it will be the name as listed in UZI, AGB or by the healthcare center.

            ShortNameInformation
            Comments

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

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

            1. There is more than 1 name
            2. Use = usual
            3. Period is current to the date of the usage
            4. Use = official
            5. Other order as decided by internal business rules.
            Control1..*
            TypeHumanName
            Is Modifierfalse
            Summarytrue
            Requirements

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

            Alternate NamesNaamgegevens
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on Practitioner.name. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ use
            • 32. Practitioner.name:nameInformation
              Slice NamenameInformation
              Definition

              This slice represents the person's official name information, including given names, last name and possibly the partner's last name.

              ShortNameInformation
              Comments

              This .name element accomodates the official parts of a Dutch name according to common international usage and optionally to the zib NameInformation v1.1 (2020). An official Dutch name is represented in FHIR as an ordinary international name, optionally augmented using extensions to specify how the last name is built up according to the Dutch rules if conformance to the zib is required. See the guidance on .family and on .extension:nameUsage for more information.

              Systems that need to work in a Dutch context SHOULD support the extensions as specified in .given, .family and .extension:nameUsage. In addition, systems SHOULD use the core elements according to the FHIR specifications to provide compatibility outside Dutch contexts. This means that:

              • If parts of the name are specified using one or more of the structured elements, the .text element SHOULD be populated with a rendered version of the full name.
              • If parts of the family name are specified using the extensions in .family, the .family element SHOULD be populated with the full family name.

              Note 1: The zib cannot be represented straightforward in FHIR. Especially note the guidance on .given on how to map the FirstNames and Initials concepts, and on .prefix/.suffix on how to map the Titles concept.

              Note 2: This element should only contain a person's official names. The GivenName concept is represented in another .name element with .name.use = usual.

              Note 3: The examples illustrate how the zib is mapped to FHIR.

              Control0..2
              This element is affected by the following invariants: ele-1
              TypeHumanName(nl core NameInformation)
              Is Modifierfalse
              Standard StatusNormative (from Trial Use)
              Summarytrue
              Requirements

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

              Alternate NamesNaamgegevens, nl-core-NameInformation
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              zib-NameInformation-1: If a prefix for a family name is specified, the family name is expected as well (family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not())
              zib-NameInformation-2: If the prefix for a partner family name is specified, the partner family name is expected as well (family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not())
              nl-core-NameInformation-01: If parts of the name are specified using one or more of the structured elements, the `.text` element SHOULD be populated with a rendered version of the full name. This ensures compatibility with common FHIR usage. ((family.exists() or given.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier').where(value != 'IN').exists()) implies text.hasValue())
              34. Practitioner.name:nameInformation-GivenName
              Slice NamenameInformation-GivenName
              Definition

              This slice represents the name information normally used to address the person.

              ShortName of a human - parts and usage
              Comments

              This .name element represents the Dutch given name ("roepnaam") according to the zib NameInformation v1.1 (2020).

              Note 1: This element should only contain a person's unofficial name. The official names are represented in one or more other .name elements with .name.use = official.

              Note 2: The examples illustrate how the zib is mapped to FHIR.

              Control0..*
              This element is affected by the following invariants: ele-1
              TypeHumanName(nl core NameInformation.GivenName)
              Is Modifierfalse
              Standard StatusNormative (from Trial Use)
              Summarytrue
              Requirements

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

              Alternate Namesnl-core-NameInformation.GivenName
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              36. Practitioner.telecom
              Definition

              Health professional’s telephone number(s) or e-mail address(es).

              ShortContactInformation
              Comments

              The cardinality mismatch between the zib (0..1) and FHIR (0..*) is explained by the containers TelephoneNumbers (0..*) and EmailAddresses (0..*) inside the ContactInformation model. The FHIR datatype ContactPoint does not have these containers.

              Control0..*
              TypeContactPoint
              Is Modifierfalse
              Summarytrue
              Requirements

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

              Alternate NamesContactgegevens
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on Practitioner.telecom. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • profile @ $this
              • 38. Practitioner.telecom:telephoneNumbers
                Slice NametelephoneNumbers
                Definition

                Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

                ShortTelephoneNumbers
                Comments

                Implementation of the "TelephoneNumbers" concept of zib ContactInformation.

                Please note that, although the zib concepts TelecomType and NumberType are functionally equivalent to the FHIR concepts ContactPoint.system and ContactPoint.use respectively, a mismatch occurs on the concept of mobile phone numbers; the zib uses the first concept and FHIR the second. For this reason, the ValueSet on ContactPoint.system is too narrow and the zib code will need to be communicated using the ext-CodeSpecification extension.

                Control0..*
                This element is affected by the following invariants: ele-1
                TypeContactPoint(nl core ContactInformation TelephoneNumbers)
                Is Modifierfalse
                Standard StatusNormative (from Trial Use)
                Summarytrue
                Requirements

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

                Alternate NamesTelefoonnummers, nl-core-ContactInformation-TelephoneNumbers
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                cpt-2: A system is required if a value is provided. (value.empty() or system.exists())
                40. Practitioner.telecom:emailAddresses
                Slice NameemailAddresses
                Definition

                Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

                ShortEmailAddresses
                Comments

                Implementation of the "EmailAddresses" concept of zib ContactInformation.

                Control0..*
                This element is affected by the following invariants: ele-1
                TypeContactPoint(nl core ContactInformation EmailAddresses)
                Is Modifierfalse
                Standard StatusNormative (from Trial Use)
                Summarytrue
                Requirements

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

                Alternate NamesEmailAdressen, nl-core-ContactInformation-EmailAddresses
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                cpt-2: A system is required if a value is provided. (value.empty() or system.exists())
                42. Practitioner.address
                Definition

                An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world.

                ShortAddressInformation
                Comments

                This datatype defines a common basis for expressing all addresses around the world, but adds extensions to express Dutch addresses specifically, according to the zib AddressInformation v1.1 (2020). A Dutch Address still is a proper FHIR Address, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype.

                To have true compatibility an implementer SHOULD use the core Address parts as intended. To have addresses work for Dutch context, the implementer SHOULD in addition use the extension elements.

                Separate address parts

                The first addition is that Dutch addresses make certain address parts separately communicable. These parts are required for use in true Dutch systems when dealing with Dutch addresses, but may not have value for international systems when information gets sent abroad.

                Custom address types

                The second addition is that the zib defines its own ValueSet for address types, which can only be partially expressed using the FHIR Address datatype and requires a mapping to multiple elements. The table below explains how the zib concepts are mapped to the various FHIR elements (see the ConceptMaps http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressUse and http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressType as well). The code from the zib should also be included using the extension on Address.extension:addressType.

                zib .ext:addressType .use .type
                Postal Address/Postadres PST postal
                Primary Home/Officieel adres HP home both
                Visit Address/Woon-/verblijfadres PHYS home physical
                Temporary Address/Tijdelijk adres TMP temp
                Work Place/Werkadres WP work
                Vacation Home/Vakantie adres HV temp

                If Address.type is both then this is to be understood as a dual purpose address (postal and physical), unless a specific postal type address is added. Systems that support importing it like this are encouraged to do so, otherwise they may need to import this as two separate addresses.

                Note: FHIR core defines the AD-use extension to further specify the postal address type. However, the ValueSet used in that extension doesn't completely match the zib ValueSet. Therefore, a custom extension has been made. This doesn't preclude the use of the AD-use extension.

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

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

                Alternate NamesAdresgegevens, nl-core-AddressInformation
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                44. Practitioner.gender
                Definition

                Patient’s administrative gender.

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

                Use ConceptMap GeslachtCodelijst-to-AdministrativeGender to translate terminology from the functional model to profile terminology in ValueSet AdministrativeGender. This ConceptMap is based on GeslachtCodelijst as defined in the zib Patient to avoid duplication of ConceptMaps. The GeslachtCodelijst of Patient and HealthProfessional are identical in terms of codes.

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

                Needed to address the person correctly.

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

                unique id for the element within a resource (for internal references)

                Shortxml:id (or equivalent in JSON)
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                48. Practitioner.gender.extension
                Definition

                May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                ShortAdditional content defined by implementations
                Comments

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

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

                  Optional Extension Element - found in all resources.

                  ShortOptional Extensions Element
                  Comments

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

                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension(ext CodeSpecification) (Extension Type: CodeableConcept)
                  Is Modifierfalse
                  Standard StatusNormative (from Trial Use)
                  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())
                  52. Practitioner.gender.extension:genderCodelist.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
                  54. Practitioner.gender.extension:genderCodelist.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

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

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on Practitioner.gender.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 56. Practitioner.gender.extension:genderCodelist.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 Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification
                    58. Practitioner.gender.extension:genderCodelist.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
                    Control0..1
                    BindingThe codes SHALL be taken from GeslachtCodelijst
                    (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.17.1.8--20200901000000)
                    TypeCodeableConcept
                    [x] NoteSeeChoice of Data Typesfor 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()))
                    60. Practitioner.gender.value
                    Definition

                    Primitive value for code

                    ShortPrimitive value for code
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    62. Practitioner.birthDate
                    Definition

                    The date of birth for the practitioner.

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

                    Needed for identification.

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

                    Image of the person.

                    ShortImage of the person
                    Control0..*
                    TypeAttachment
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

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

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

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

                    ShortCertification, licenses, or training pertaining to the provision of care
                    Control0..*
                    TypeBackboneElement
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    68. Practitioner.qualification.id
                    Definition

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

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

                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional content defined by implementations
                    Comments

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

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    72. Practitioner.qualification.modifierExtension
                    Definition

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

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

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

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

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

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

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

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

                    ShortAn identifier for this qualification for the practitioner
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..*
                    TypeIdentifier
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    Often, specific identities are assigned for the qualification.

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

                    Coded representation of the qualification.

                    ShortCoded representation of the qualification
                    Control1..1
                    BindingFor example codes, see v2 table 0360, Version 2.7
                    (example to http://terminology.hl7.org/ValueSet/v2-2.7-0360)

                    Specific qualification the practitioner has to provide a service.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    78. Practitioner.qualification.period
                    Definition

                    Period during which the qualification is valid.

                    ShortPeriod during which the qualification is valid
                    Control0..1
                    TypePeriod
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

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

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

                    Organization that regulates and issues the qualification.

                    ShortOrganization that regulates and issues the qualification
                    Control0..1
                    TypeReference(Organization)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    82. Practitioner.communication
                    Definition

                    A language the practitioner can use in patient communication.

                    ShortA language the practitioner can use in patient communication
                    Comments

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

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

                    A human language.

                    Additional BindingsPurpose
                    AllLanguagesMax Binding
                    TypeCodeableConcept
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

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

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