Introduction to the technical specification

Table of contents

1 Profiles in the CareCommunication Standard
2 Internal references in a CareCommunication

1 Profiles in the CareCommunication Standard

Only the top-level elements directly under the resource are listed in the overview in Table 1. To see MustSupport for the underlying child elements, you need to consult the Implementation Guide for the specific resource, which is linked in the left side of Table 1.

In case of any discrepancies between the MedCom CareCommunication IG and this page, the IG page should be followed. Please contact fhir@medcom.dk if you find any discrepancies.

There is a difference between the required elements and MustSupport elements, as the required element always shall be included in a message. MustSupport elements must be included if they are present in the sender’s system, and the receiver must be able to handle the information if it is included in a message.

Table 1: Overview of the profiles in the CareCommunication standard
Profile	Resource	Description	MustSupport elements (Top-level elements only)	Implementation Guide Origin
MedComCareCommunicationMessage	Bundle	Acts as a container for the content of the message Inherited from the MedComMessagingMessage	id type timestamp entry	CareCommunication
MedComCareCommunicationMessageHeader	MessageHeader	The header of a MedComCareCommunication message, which must always be the first referenced profile, when the type of the bundle is 'message'.This profile holds references to the fundamental information in a message, such as sender, receiver, and the content of the message in terms of the CareCommunication profile. Inherited from MedComMessagingMessageHeader	id text event[x] destination:primary sender source focus definition	CareCommunication
MedComCareCommunication	Communication	The MedComCareCommunication profile contains the main content of the message in form of a message segment. A message segment consists of the textual part (payload:string.content[x]) and a signature which includes an author (payload:string.extension.author), a timestamp (payload:string.extension:date) and a relevant telephone number (payload:string.extension.authorContact), or an attachment (payload:attachment.content[x]). The message must include a category code (category) and it may include a topic (topic) that supports and elaborates the category. Further, it is possible to include an episodeOfCare-identifier, by referencing an Encounter resource (encounter). A more specific sender and recipient of the message may be referenced from the elements recipient and extension.sender.	id text extension.sender identifier status category priority subject topic encounter recipient payload:string payload:attachment	CareCommunication
MedComCorePatient	Patient	Describes a citizen or patient in which the communication concerns when exchanging a CareCommunication.	id text identifier:cpr identifier:x-ecpr identifier:d-ecpr name:official telecom address	Core
MedComCorePractitioner	Practitioner	Describes a healthcare professional or another actor involved in citizen or patient care. This profile is used to describe the author and sender or recipient. MedComCorePractitioner is inherited from the DkCorePractitioner, and must include a name of the practitioner if available.	id text name	Core
MedComCorePractitionerRole	PractitionerRole	Describes the role of a healthcare professional or another actor involved in citizen or patient care. This profile is used to describe the author role and sender or recipient.	id text practitioner organization code	Core
MedComCoreEncounter	Encounter	Describes the interaction between a patient and one or more healthcare providers. The Encounter holds the episodeOfCare-identifier.	id text status class subject episodeOfCare:All Slices episodeOfCare:lpr3identifier serviceProvider	Core
MedComCoreCareTeam	CareTeam	Describes one or more professionals who plan to participate in the coordination and delivery of care for a patient or citizen. It may be used as the sender or recipient from the MedComCareCommunication profile	id text name managingOrganization	Core
MedComMessagingOrganization	Organization	Contains information which is useful to identify a sender or receiver organization. It is primarily used for transportation matters, why it must contain a SOR and EAN identifier. This profile inherits from MedComCoreOrganization.	id text identifier:EAN-ID identifier:SOR-ID name	Messaging
MedComCareCommunicationProvenance	Provenance	Describes the activity of a message, e.g. if the message is a new message or a modified message. In case of a previously sent message, the Provenance resource holds a reference to this message. Therefore, it is possible to get an overview of the communication about a patient.	id text target occurred[x]:occurredDateTime recorded activity agent entity:All Slices entity:preceedingMessage entity:payload	CareCommunication
MedComCoreOrganization	Organization	Contains information about an organization. The Organization is referenced from Practitioner or CareTeam.	id text identifier:SOR-ID name	Core

1.1 Sender and recipient

In a CareCommunication, it is required to include information about a sender and receiver in terms of a reference to a MedComMessagingOrganization. This information is primarily used for transportation matters and will always include an EAN and SOR identifier.

When sending a CareCommunication, it is possible to add a more specific receiver of the message, called a recipient, and a more specific sender. This may be used to include a more specific group of people or a person related to the care, and wellbeing of the patient or citizen can be referenced. An example could be to address a specific general practitioner by name, a specific care team in a municpality or eventually a specific social unit within the social care sector in a municipality.

1.2 Categories and the use of priority

There is a nationally agreed list of categories that must be used when sending a CareCommunication.
The list of categories can be seen here.
When a category is of the type ‘regarding-referral’ it is allowed to add a priority, which can be ‘asap’ or ‘routine’. When the category ‘other’ is chosen, a topic must be included, as this is used to specify the topic of the CareCommunication.

1.3 Encounter and episodeOfCare-identifier

When receiving a message, either CareCommunication or EDIFACT/OIOXML message, there will in many cases be an episodeOfCare-identifier, as it describes the id of the contact. If this is the case, it shall always be included in the response. An Encounter profile contains the possibility to include an episodeOfCare-identifier, that contains this id.

2 Internal references in a CareCommunication

The CareCommunication follows MedCom’s generic messaging model.
The references between the profiles are shown in the CareCommunication Implementation Guides Home page. The MedComCareCommunicationMessage profile acts as the container which includes the other profiles. From the MedComCareCommunicationMessageHeader the sender and receiver organisations are referenced as the MedComMessagingOrganization together with the focus of the message, which is the MedComCareCommunication profile. This profile must always reference a subject of the type MedComCorePatient.
MedComCareCommunicationProvenance is used to keep track of the messaging history and define the activity of the communication. The Provenance references the MedComCareCommunicationMessageHeader as the target and the actor in terms of a MedComMessagingOrganization.

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