HealthcareService

Introduction

Scope and Usage

The HealthcareService resource is used to describe a single healthcare service or category of services that are provided by an organization at a location. General categories of services, such as "Radiology" are typically not directly schedulable, but would be more specific services like "CT Scan" which are specific services within Radiology.
The location of the services could be virtual, as with telemedicine services.

HealthcareService is the intersection of Organization, Location and Service. It can also be used as actor, e.g. as performer/requester/recipient (therefore it is also available on the request and the event pattern in such roles). In such cases the meaning of "HealthcareService A ordered B" translates to "The collection of people who work with/for HealthcareService A ordered B"

Common examples of HealthcareServices that may be offered at an organization/location include:

• Clinical Neuropsychologist
• Podiatry Service
• Smallville Hospital Emergency Services
• Respite care provided at a nursing home or hostel
• 24hr crisis telephone counseling service
• Information, advice and/or referral services; Disability, Telecommunications
• Rural TeleHealth Services
• Hospital in the home
• Yellow Cabs
• Pharmacy
• Active Rehab
• Social Support
• Drug and/or alcohol counseling
• Day Programs, Adult Training & Support Services
• Consulting psychologists and/or psychology services
• Group Hydrotherapy
• Little River Home Maintenance
• CT Head Scan (multiple instances for variations such as with or w/o Contrast)

HealthcareService resources do not represent Computer related Services (not SOA)

Example uses of HealthcareService resources are:

• National Services Directory - Consumer Focus
• National Services Directory - Practitioner Referrals Searching
• Organization's Client Portal - to locate services / book appointments
• Address book of services for Referrals
  including references to Questionnaires for assessments that are required as part of the referral
• Health Network internal directory Used for tracking available services offered internally, and also those offered by business partners.
  This information may also include costing information.
• Catalog of schedulable services or activities at a location/organization

Boundaries and Relationships

The HealthcareService resource can be used with the Schedule resource to define actual availability of the service. This would be done by using the Schedule's Actor property.

When creating an Appointment, the HealthcareService is to be assigned to one of the participants.
It is up to the scheduling system to determine if the service is available and can be accepted.

The HealthcareService resource is used with the following resources:

• Organization: The organization provides the services, the healthcareservice describes the services
• ServiceRequest: This is a subject specific request for a specific service, it may be to a specific healthcare service, and/or simply a coded service value. The granularity included in the request codes may be finer than defined in the healthcare service.
• OrganizationAffiliation: Might constrain a list of healthcare services that are available between 2 organizations
• Location: Specifies the place where the service(s) are offered/available within.

Notes

Notes:

• The HealthcareService could be mapped to components of the IHE Care Services Directory, and/or the OMG ServD standards

Single or Multiple Locations

When deciding to whether to use multiple locations on a single HealthcareService, or create multiple HealthcareService resources for each location on each you should consider:

• are availability hours different? (hours of operation on location - and why they can be different) - e.g. some services are only available for restricted hours
• are contact details different? (special contact number for service, not a location based number)
• are endpoint details different?
• are there different characteristics at different locations? (e.g. wheelchair accessible)
• are the coverageAreas the different?
• how is all this data managed - and does it cause resources to need to be split/merged when things change (and what impact does that have downstream - i.e. replicated directories)

Any/all of these factors could require constraining the use down to a single location on the resource and create separate HealthcareService resources covering the details of the referenced Location.

In a case where all this data is the same across all locations, then a single HealthcareService resource instance can be used with all the locations listed on it.

Note that if the contact/availability/endpoint details of the HealthcareService are the same as the Location, then these may be omitted from the HealthcareService and use the Location (thus reducing administrative burden)

StructureDefinition

Elements (Simplified)

• HealthcareService [0..*]: - The details of a healthcare service available at a location
• HealthcareService.identifier [0..*]: Identifier External identifiers for this item
• HealthcareService.active [0..1]: boolean Whether this HealthcareService record is in active use
• HealthcareService.providedBy [0..1]: Reference(Organization) Organization that provides this service
• HealthcareService.offeredIn [0..*]: Reference(HealthcareService) The service within which this service is offered
• HealthcareService.category [0..*]: CodeableConcept example:service-category Broad category of service being performed or delivered
• HealthcareService.type [0..*]: CodeableConcept example:service-type Type of service that may be delivered or performed
• HealthcareService.specialty [0..*]: CodeableConcept example:c80-practice-codes Specialties handled by the HealthcareService
• HealthcareService.location [0..*]: Reference(Location) Location(s) where service may be provided
• HealthcareService.name [0..1]: string Description of service as presented to a consumer while searching
• HealthcareService.comment [0..1]: markdown Additional description and/or any specific issues not covered elsewhere
• HealthcareService.extraDetails [0..1]: markdown Extra details about the service that can't be placed in the other fields
• HealthcareService.photo [0..1]: Attachment Facilitates quick identification of the service
• HealthcareService.contact [0..*]: ExtendedContactDetail Official contact details for the HealthcareService
• HealthcareService.coverageArea [0..*]: Reference(Location) Location(s) service is intended for/available to
• HealthcareService.serviceProvisionCode [0..*]: CodeableConcept example:service-provision-conditions Conditions under which service is available/offered
• HealthcareService.eligibility [0..*]: BackboneElement Specific eligibility requirements required to use the service
• HealthcareService.eligibility.code [0..1]: CodeableConcept example:eligibility Coded value for the eligibility
• HealthcareService.eligibility.value[x] [0..1]: CodeableConcept, boolean, Quantity, Range, Reference Value associated with the eligibility code
• HealthcareService.eligibility.comment [0..1]: markdown Describes the eligibility conditions for the service
• HealthcareService.eligibility.period [0..1]: Period The period this eligibility rule applies
• HealthcareService.program [0..*]: CodeableConcept example:program Programs that this service is applicable to
• HealthcareService.characteristic [0..*]: CodeableConcept example:service-mode Collection of characteristics (attributes)
• HealthcareService.communication [0..*]: CodeableConcept required:all-languages The language that this service is offered in
• HealthcareService.referralMethod [0..*]: CodeableConcept example:service-referral-method Ways that the service accepts referrals
• HealthcareService.referralRequired [0..1]: boolean A referral is required for access to this service
• HealthcareService.appointmentRequired [0..1]: boolean An appointment is required for access to this service
• HealthcareService.availability [0..1]: Availability Times the healthcare service is available (including exceptions)
• HealthcareService.endpoint [0..*]: Reference(Endpoint) Technical endpoints providing access to electronic services operated for the healthcare service

Mappings

• HealthcareService Mappings — 34 mapping entries

Resource Packs

list-HealthcareService-packs.xml

<?xml version="1.0" encoding="UTF-8"?>

<List xmlns="http://hl7.org/fhir">
  <id value="HealthcareService-packs"/>
  <status value="current"/>
  <mode value="working"/>
</List>

Search Parameters

• active — token — The Healthcare Service is currently marked as active — HealthcareService.active
• characteristic — token — One of the HealthcareService's characteristics — HealthcareService.characteristic
• eligibility — token — One of the HealthcareService's eligibility requirements — HealthcareService.eligibility.code
• coverage-area — reference — Location(s) service is intended for/available to — HealthcareService.coverageArea
• endpoint — reference — Technical endpoints providing access to electronic services operated for the healthcare service — HealthcareService.endpoint
• offered-in — reference — The service within which this service is offered — HealthcareService.offeredIn
• identifier — token — External identifiers for this item — HealthcareService.identifier
• location — reference — The location of the Healthcare Service — HealthcareService.location
• name — string — A portion of the Healthcare service name — HealthcareService.name
• organization — reference — The organization that provides this Healthcare Service — HealthcareService.providedBy
• program — token — One of the Programs supported by this HealthcareService — HealthcareService.program
• service-category — token — Service Category of the Healthcare Service — HealthcareService.category
• service-type — token — The type of service provided by this healthcare service — HealthcareService.type
• specialty — token — The specialty of the service provided by this healthcare service — HealthcareService.specialty
• communication — token — Languages that are available at this service — HealthcareService.communication

Full Search Parameters

Examples

• example — healthcareservice-example — Example of healthcareservice
• healthcareservice-example — healthcareservice-example
• healthcareservice-examples-header — healthcareservice-examples-header

Full Examples

Mapping Exceptions

healthcareservice-fivews-mapping-exceptions.xml

Unmapped Elements

• FiveWs.what — Unknown
• FiveWs.recorded — Unknown
• FiveWs.author — Unknown
• FiveWs.actor — Unknown
• FiveWs.cause — Unknown
• FiveWs.version — Unknown
• FiveWs.witness — Unknown
• FiveWs.context — Unknown
• FiveWs.init — Unknown
• FiveWs.why — Unknown
• FiveWs.source — Unknown
• FiveWs.who — Unknown
• FiveWs.grade — Unknown
• FiveWs.planned — Unknown
• FiveWs.done — Unknown
• FiveWs.subject — Unknown

healthcareservice-participant-mapping-exceptions.xml

Divergent Elements

• Participant.identifier → HealthcareService.identifier
  • shortUnmatched | reason=Unknown | pattern=Business Identifier for healthcare service | resource=External identifiers for this item
  • definitionUnmatched | reason=Unknown | pattern=Business identifiers assigned to this healthcare service by one of the applications involved. These identifiers remain constant as the resource is updated and propagates from server to server. | resource=External identifiers for this item.
  • commentsUnmatched | reason=Unknown | pattern=Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.
  • requirementsUnmatched | reason=Unknown | pattern=Allows identification of the healthcare service as it is known by various participating systems and in a way that remains consistent across servers.
• Participant.active → HealthcareService.active
  • shortUnmatched | reason=Unknown | pattern=Whether the healthcare service is currently active | resource=Whether this HealthcareService record is in active use
  • definitionUnmatched | reason=Unknown | pattern=Whether this healthcare service record is in active use. | resource=This flag is used to mark the record to not be used. This is not used when a center is closed for maintenance, or for holidays, the notAvailable period is to be used for this.
• Participant.name → HealthcareService.name
  • shortUnmatched | reason=Unknown | pattern=A name for the healthcare service | resource=Description of service as presented to a consumer while searching
  • definitionUnmatched | reason=Unknown | pattern=Description of the healthcare service as presented to a consumer while searching. | resource=Further description of the service as it would be presented to a consumer while searching.