The health professional identification number is a number that uniquely identifies the health professional.

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.

• value @ system

Unieke Zorgverlener Identificatie (Dutch physician identification number)

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.

Dutch names require that certain name parts are separately communicable. For this reason, extensions are added onto the base HumanName element to mark the meaning of each part. A Dutch HumanName is still a proper FHIR HumanName; however, there might be an incompatibilty with the default FHIR mechanism for communicating given names. See the compatibility note below for more information.

The extension elements cover birth name (NL: eigennaam / geslachtsnaam) and partner/spouse name. Both may have a prefix (NL: voorvoegsel). When a person marries, he or she may keep their own name, assume the partner name, append the partner name to their own name, or the other way around.

Incompatibility note: It has come to light that this specification deviates from the way that the HumanName datatype is normally used. This will be fixed in a future release. However, current implementations should be aware of the special considerations regarding the use of this specification.

The issue at hand is the way alternative representations of a name, like initials or a nickname, are communicated. Normally this is done using multiple HumanName instances, which are differentiated using the .use element. However, this specification allows for including all alternative representations in the same HumanName instance, with the expectation that the extensions provide enough information for receiving systems to differentiate them. However, this means that contrary to the normal usage of this datatype, repetitions of .given names cannot be concatenated to get the full list of given names; the list might be a mix of full names, nicknames and initials.

Since multiple implementations are based on this specification, sending systems are advised (but not required) to keep the approach with one HumanName instance, while receiving systems should be able to handle this one-instance approach. More specifically:

• Sending and receiving systems SHOULD always use the specified extensions when using this datatype.
• Sending systems are encouraged to populate the .text element to unambigiously communicate the person's name.
• Sending systems are encouraged to send either the full given names or the initials, but not both. This alleviates the duplication of names in .given.
• When a sending system uses the current one-instance approach for communicating multiple representations, .use MAY NOT be populated. After all, it is not possible to select a single .use when the instance contains different representations.
• When a receiving system interprets the instance as the single-instance-multiple-representations approach, the .given names marked as initials SHOULD be interpreted as alternatives to the full given names. Note the underlying HCIM expects both the list of full names and list of initials to be a single string; there's no match for an initial to a full name. The instance SHOULD be regarded as using this approach when:
• They encounter a single instance
• And the .use element is absent
• And all the name parts are differentiated using the specified extensions
• In any other circumstance, receiving systems SHOULD interpret the usage as the normal use.

Example: miss Irma Jongeneel marries mister de Haas and assumes the name Irma Jongeneel-de Haas:

• .family = "Jongeneel-de Haas"
• .given = "Irma" (with .given:iso21090EnQualifier = BR)
• .family:humannameOwnName = "Jongeneel"
• .family:humannamePartnerPrefix = "de "
• .family:humannamePartnerName = "Haas"

This datatype defines a common basis for expressing all addresses around the world, but adds extensions to express Dutch addresses specifically, according to the HCIM AddressInformation (v1.0, 2017). 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 HCIM 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 HCIM 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 HCIM code itself should also be included using the AddressType extension.

| HCIM |.ext:AddressType | .ext:official | .use | .type | |-----------------------------------|:------------------:|:---------------:|:------:|:----------:| | Postal Address/Postadres | PST | | | postal | | Primary Home/Officieel adres | HP | true | home | | | 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). 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 HCIM ValueSet. Therefore, a custom extension has been made. This doesn't preclude the use of the AD-use extension.

Note: address is for postal addresses, not physical locations.

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

Note that a cab driver no longer fits the bill. You probably would be interested in the organization rather than the individual?

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

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

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

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

The base language in which the resource is written.

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).

A 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.

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.

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.

May be used to represent additional information that is not part of the basic definition of the resource. In order 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.

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.

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. Usually modifier elements provide negation or qualification. In order 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.

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.

The health professional identification number is a number that uniquely identifies the health professional.

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.

Often, specific identities are assigned for the agent.

• value @ system

Unieke Zorgverlener Identificatie (Dutch physician identification number)

Often, specific identities are assigned for the agent.

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

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

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.

• value @ url

The purpose of this identifier.

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Allows users to make use of identifiers when the identifier system is not known.

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.

Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.

Time period during which identifier is/was valid for use.

Organization that issued/manages the identifier.

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

An identifier that applies to this person in this role.

Often, specific identities are assigned for the agent.

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

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

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.

• value @ url

The purpose of this identifier.

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Allows users to make use of identifiers when the identifier system is not known.

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.

Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.

Time period during which identifier is/was valid for use.

Organization that issued/manages the identifier.

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

An identifier that applies to this person in this role.

Often, specific identities are assigned for the agent.

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

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

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.

• value @ url

The purpose of this identifier.

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Allows users to make use of identifiers when the identifier system is not known.

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.

Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.

Time period during which identifier is/was valid for use.

Organization that issued/manages the identifier.

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Whether this practitioner's record is in active use.

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

Default is true.

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.

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) 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.

Dutch names require that certain name parts are separately communicable. For this reason, extensions are added onto the base HumanName element to mark the meaning of each part. A Dutch HumanName is still a proper FHIR HumanName; however, there might be an incompatibilty with the default FHIR mechanism for communicating given names. See the compatibility note below for more information.

The extension elements cover birth name (NL: eigennaam / geslachtsnaam) and partner/spouse name. Both may have a prefix (NL: voorvoegsel). When a person marries, he or she may keep their own name, assume the partner name, append the partner name to their own name, or the other way around.

Incompatibility note: It has come to light that this specification deviates from the way that the HumanName datatype is normally used. This will be fixed in a future release. However, current implementations should be aware of the special considerations regarding the use of this specification.

The issue at hand is the way alternative representations of a name, like initials or a nickname, are communicated. Normally this is done using multiple HumanName instances, which are differentiated using the .use element. However, this specification allows for including all alternative representations in the same HumanName instance, with the expectation that the extensions provide enough information for receiving systems to differentiate them. However, this means that contrary to the normal usage of this datatype, repetitions of .given names cannot be concatenated to get the full list of given names; the list might be a mix of full names, nicknames and initials.

Since multiple implementations are based on this specification, sending systems are advised (but not required) to keep the approach with one HumanName instance, while receiving systems should be able to handle this one-instance approach. More specifically:

• Sending and receiving systems SHOULD always use the specified extensions when using this datatype.
• Sending systems are encouraged to populate the .text element to unambigiously communicate the person's name.
• Sending systems are encouraged to send either the full given names or the initials, but not both. This alleviates the duplication of names in .given.
• When a sending system uses the current one-instance approach for communicating multiple representations, .use MAY NOT be populated. After all, it is not possible to select a single .use when the instance contains different representations.
• When a receiving system interprets the instance as the single-instance-multiple-representations approach, the .given names marked as initials SHOULD be interpreted as alternatives to the full given names. Note the underlying HCIM expects both the list of full names and list of initials to be a single string; there's no match for an initial to a full name. The instance SHOULD be regarded as using this approach when:
• They encounter a single instance
• And the .use element is absent
• And all the name parts are differentiated using the specified extensions
• In any other circumstance, receiving systems SHOULD interpret the usage as the normal use.

Example: miss Irma Jongeneel marries mister de Haas and assumes the name Irma Jongeneel-de Haas:

• .family = "Jongeneel-de Haas"
• .given = "Irma" (with .given:iso21090EnQualifier = BR)
• .family:humannameOwnName = "Jongeneel"
• .family:humannamePartnerPrefix = "de "
• .family:humannamePartnerName = "Haas"

Contact information includes a person's telephone numbers and email addresses. This datatype defines a common basis for expressing all contact information around the world, but adds extensions to express Dutch contacts specifically, according to the HCIM ContactInformation (v1.0, 2017). A Dutch ContactPoint still is a proper FHIR ContactPoint, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype. The table below explains how the HCIM concepts are mapped to the various FHIR elements. The HCIM code itself should also be included using the TelecomType extension.

| HCIM | .ext:TelecomType | .system | .use | |----------------------------------------------------|:------------------:|:---------:|:--------:| | Primary Home Land Line | LL | phone | home | | Temporary Land Line | LL | phone | temp | | Primary Work Land Line | LL | phone | work | | | | | | | Primary Home Fax | FAX | fax | home | | Temporary Fax | FAX | fax | temp | | Primary Work Fax | FAX | fax | work | | | | | | | Primary Home Mobile Phone | MC | phone | home | | Temporary Mobile Phone | MC | phone | temp | | Primary Work Mobile Phone | MC | phone | work | | | | | | | Primary Home Pager | PG | pager | home | | Temporary Pager | PG | pager | temp | | Primary Work Pager | PG | pager | work | | | | | | | Private email address | | email | home | | Work email address | | email | work | | | | | | | Mobile phone number undetermined private/business | | phone | mobile |

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

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 also to help with identification

These typically will have home numbers, or mobile numbers that are not role specific.

This datatype defines a common basis for expressing all addresses around the world, but adds extensions to express Dutch addresses specifically, according to the HCIM AddressInformation (v1.0, 2017). 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 HCIM 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 HCIM 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 HCIM code itself should also be included using the AddressType extension.

| HCIM |.ext:AddressType | .ext:official | .use | .type | |-----------------------------------|:------------------:|:---------------:|:------:|:----------:| | Postal Address/Postadres | PST | | | postal | | Primary Home/Officieel adres | HP | true | home | | | 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). 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 HCIM ValueSet. Therefore, a custom extension has been made. This doesn't preclude the use of the AD-use extension.

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.

Note: address is for postal addresses, not physical locations.

Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes.

Needed to address the person correctly.

The date of birth for the practitioner.

Needed for identification.

Image of the person.

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

Qualifications obtained by training and certification.

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

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

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.

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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

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.

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

Often, specific identities are assigned for the qualification.

Coded representation of the qualification.

Period during which the qualification is valid.

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

Organization that regulates and issues the qualification.

A language the practitioner is able to use in patient communication.

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

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