3.3.0 - consultation responses

input/fsh/DkCorePatient.fsh

@@ -186,7 +186,7 @@ Usage: #example
 * birthDate = "1992-03-07"
 
 Invariant: marital-status-unknown-usage
-Description: "Status in maritalStatus is unknown in a danish context. Consider mapping the value to UNK. See https://cpr.dk/borgere/hvad-staar-der-om-mig-i-cpr-registerindsigt/hvad-og-hvem-er-registreret-i-cpr-og-hvem-opdaterer-oplysninger-om-dig-i-cpr/"
+Description: "The constraint ensures that only permitted forms of marriage can be used in the Danish context, as there will be no authority for other forms. See https://cpr.dk/borgere/hvad-staar-der-om-mig-i-cpr-registerindsigt/hvad-og-hvem-er-registreret-i-cpr-og-hvem-opdaterer-oplysninger-om-dig-i-cpr/"
 Severity: #warning
 Expression: "maritalStatus.coding.where(code = 'P' and system = 'http://terminology.hl7.org/CodeSystem/v3-MaritalStatus').empty() or maritalStatus.coding.where(code = 'A' and system = 'http://terminology.hl7.org/CodeSystem/v3-MaritalStatus').empty()"
 * requirements = "Marital status is legally unknown in Denmark"

input/fsh/codeSystems.fsh

@@ -779,6 +779,9 @@ Title: "DK Role Code"
 * #POWATT
   * ^designation.language = #da
   * ^designation.value = "Fuldmagtshaver"
+* #ECON
+  * ^designation.language = #da
+  * ^designation.value = "Primær kontakt"
 
 CodeSystem: DkRelatedPersonRelationshipCodes
 Id: dk-relatedperson-relationshipcodes
@@ -798,3 +801,7 @@ Description: "DK Related Person Relationship Codes"
   * ^definition = "The player of the role is the primary caretaker of the scoping person."
   * ^designation.language = #da
   * ^designation.value = "Primær omsorgsperson"
+* #PROCON "Professional contact" 
+  * ^definition = "A professional acting as a contact of the scoping person."
+  * ^designation.language = #da
+  * ^designation.value = "Professionel kontakt"

input/fsh/valueSets.fsh

@@ -281,4 +281,5 @@ Description: "DK Related Person Relationship Types"
 * $v3-RoleCode#GUARD // "guardian"
 * $v3-RoleCode#NOK // "next of kin"
 * $v3-RoleCode#POWATT // "power of attorney"
+* $v3-RoleCode#ECON // "emergency contact"
 * include codes from system DkRelatedPersonRelationshipCodes

input/pagecontent/StructureDefinition-dk-core-patient-intro.md

@@ -9,7 +9,7 @@ This patient profile currently only reflects the use of the established national
 
 #### CPR-identifier
 
-The element identifier.type describes the specific purpose of an identifier. It is desired to use the code 'NNDNK' from the CodeSystem [IdentifierType](https://terminology.hl7.org/4.0.0/CodeSystem-v2-0203.html) as the type for [DkCoreCprIdentifier](https://hl7.dk/fhir/core/StructureDefinition-dk-core-cpr-identifier.html). However, it is currently not recommended to use this code, due to known problems with the validation tool when validating the code 'NNDNK'.
+The element identifier.type describes the specific purpose of an identifier. It is desired to use the code 'NNDNK' from the CodeSystem [IdentifierType](https://terminology.hl7.org/4.0.0/CodeSystem-v2-0203.html) as the type for [DkCoreCprIdentifier](https://hl7.dk/fhir/core/StructureDefinition-dk-core-cpr-identifier.html). Due to known problems with the validation tool when validating the code 'NNDNK', including this type will cause an error. Therefore, it is currently not recommended to use this code.
 
 #### eCPR-identifier
 
@@ -39,8 +39,12 @@ The tabel below shows how to convert between CPR-registry civilstand/status and
 |civilstand = O indicating 'ophørt registreret partner'/disolved partnership. When the marriage-like partnership is disolved (parallel to a divorce) |Patient.maritalStatus = O|
 |civilstand = L indicating that the registrered partner of the person is dead (parallel to a widow) |Patient.maritalStatus = W|
 
+### Linking records
+In Denmark it is possible to get a new CPR-number when a person e.g. changes his or her legal gender. Linking of the old and new patient records can handled using the Patient.link element, which asserts that patient resources refer to the same patient. In this case the old record should have the link type 'replaced-by' where the new record may have the link type 'replaces', both with a reference to the other record. This way of linking record can be considered in the case of legal gender. Other types of linking is described on [the page for the patient resource](https://hl7.org/fhir/r4/patient.html#links).
+
+
 ### Use of security label on patients
- Danish citizens that have requested name and address protection ([Navne- og adressebeskyttelse](https://www.retsinformation.dk/eli/lta/2017/646#idee1fb7b6-c7e7-429d-a738-881c5e486fa6)) should be labeled with the security label as follows:
+In case an implementation project needs to support name and address protection ([Navne- og adressebeskyttelse](https://www.retsinformation.dk/eli/lta/2017/646#idee1fb7b6-c7e7-429d-a738-881c5e486fa6)) of a danish citizen, it is recommended to support this with the security label as follows:
 
  ```
  <Patient xmlns="http://hl7.org/fhir">
@@ -58,4 +62,5 @@ The tabel below shows how to convert between CPR-registry civilstand/status and
 Use of this label should be interpreted according to the law, roughly meaning that only personnel using systems in public/official affairs are allowed to see name and address for the patient/citizen.
 
 ### Unknown values or Absent values
-There may be scenarios where it is not possible to supply all values as required by this profile. For such cases it is possible to specify a Data Absent Reason ([DAR](https://hl7.org/fhir/R4/extension-data-absent-reason.html)) extension which enables data fields to be supplied where data is not available. An example of this can be seen [here](./Patient-ukendt.html). The use of DAR is not restricted to the patient profile.
+There may be scenarios where it is not possible to supply all values as required by this profile. For such cases it is possible to specify a Data Absent Reason ([DAR](https://hl7.org/fhir/R4/extension-data-absent-reason.html)) extension which enables data fields to be supplied where data is not available. An example of this can be seen [here](./Patient-ukendt.html). The use of DAR is not restricted to the patient profile.
+

input/pagecontent/StructureDefinition-dk-core-related-person-intro.md

@@ -1,7 +1,11 @@
 ### Scope and usage
 The Danish Core Related Person profile is intended to encapsulate the most common and basic data model of persons related to patients/persons in Danish healthcare systems covering both primary sector, secondary sector (specialty doctors and hospitals) and municipality cases. As such the profile should be usable in most Danish contexts. Note that the profile is usable for related persons to those that receive health and social care in municipalities, even in contexts where receivers of care are more commonly known as citizens ([DA] borgere).
 
-Note also, that the intended use of Related Person is to describe a relationship in itself and that privileges which might be associated to a relationship (e.g. power of attorney) should be expressed by other means.  
+Note, that professional relationships between a patient and a healthcare professional are expressed by other means e.g. through `Patient.generalPractitioner`.   
+
+Note also, that the intended use of Related Person is to describe a relationship, where privileges which might be associated to the relationship should be expressed by other means, e.g.the actual rights associated with being power of attorney, should be described in a legally binding document, and that document can be represented with the Consent resource.
+
+Note furthermore, that a patients primary contact when possible should be expressed through `Patient.contact`. However, when this is not feasible Related Person may be used.
 
 ### Identifiers for related persons
 This related person profile currently reflects the use of the established national Danish citizen identifiers called [CPR](https://cpr.dk/) and (where relevant) the use of replacement CPR numbers ([DA] Erstatnings-CPR-numre eller eCPR).
@@ -17,10 +21,10 @@ The element RelatedPerson.identifier includes two slices to represent eCPR. Each
 * For D-eCPR, the [DkCoreDeCprIdentifier](./StructureDefinition-dk-core-d-ecpr-identifier.html) must be used, which includes a ValueSet of OID's that may be used as system. The OIDs represent the D-eCPR in general and D-eCPR for each of the five regions. Further, the identifier includes an invariant describing the requirements for the structure of the identifier, [based on guidelines from Danish Health Data Authority](https://www.nspop.dk/pages/viewpage.action?pageId=226757583#eCPRFormater(XeCPRogDeCPR)-Formatetfordecentraleerstatningspersonnumre-D-eCPR).
 
 ### Relationship codes
-The relationships in [DK Core Related Person Relationship Types](ValueSet-dk-core-RelatedPersonRelationshipTypes.html) are intended to cover the most common use cases within the Danish healthcare sector. For the relationship codes that are included from the general relationship codes [danish translations](CodeSystem-role-code-dk-supplement.html) are provided. In cases when other relationships need to be expressed, codes from the general [Related Person Relationship Type](http://hl7.org/fhir/R4/valueset-relatedperson-relationshiptype.html) should be used when possible.  
+The relationships in [DK Core Related Person Relationship Types](ValueSet-dk-core-RelatedPersonRelationshipTypes.html) are intended to cover the most common use cases within the Danish healthcare sector. For the relationship codes that are included from the general relationship codes [danish translations](CodeSystem-role-code-dk-supplement.html) are provided. In cases when other relationships need to be expressed, codes from the general [Related Person Relationship Type](http://hl7.org/fhir/R4/valueset-relatedperson-relationshiptype.html) or [HL7 Role Code System](http://terminology.hl7.org/CodeSystem/v3-RoleCode) should be used when possible. In the latter system is e.g. the code 'CCO', which is a clinical companion (DA: Servicehund).  
 
 ### Use of security label on related persons
-Danish citizens that have requested name and address protection ([Navne- og adressebeskyttelse](https://www.retsinformation.dk/eli/lta/2017/646#idee1fb7b6-c7e7-429d-a738-881c5e486fa6)) should be labeled with the security label as follows:
+In case an implementation project needs to support name and address protection ([Navne- og adressebeskyttelse](https://www.retsinformation.dk/eli/lta/2017/646#idee1fb7b6-c7e7-429d-a738-881c5e486fa6)) of a danish citizen, it is recommended to support this with the security label as follows:
 
  ```
  <RelatedPerson xmlns="http://hl7.org/fhir">