As described in https://ehealth-dk.atlassian.net/wiki/spaces/EDTW/pages/538935313/Behind+the+Scenes#Overview-of-Communication-produced-by-the-Infrastructure, the eHealth Infrastructure automatically creates FHIR Communication (of profile https://docs.ehealth.sundhed.dk/latest-released/ig/StructureDefinition-ehealth-message.html) in various situations.

It is possible to control if and how these FHIR Communication are created through use of FHIR CommunicationRequest (https://docs.ehealth.sundhed.dk/latest-released/ig/StructureDefinition-ehealth-communication-request.html ).

Adding Control of Creation of Message

To control automatic creation of FHIR Communication, create a CommunicationRequest. In addition to the CommunicationRequest elements described below, certain elements must have specific values depending on the situation in which the Infrastructure automatically creates the Communication. See the subsections below.

CommunicationRequest:

• subject = Patient reference

• occurrencePeriod.start = start of period for which the control applies

• occurrencePeriod.end = end of period for which the control applies, if known. Otherwise it can be left empty.

• status = active when control is in effect. Can be set to other values as appropriate (one of draft | active | on-hold | revoked | completed).

• doNotPerform = false (or unset) for opt-in or override of medium/payload, true in order to opt-out (that is, to suppress creation)

CommunicationRequest subject shall not be set for control of messages regarding:

• Automated creation of medium nemsms Communication when Communication with category message and Patient as recipient created

• Reminder about appointment

Controlling Creation of Message with Patient as Recipient

The table below describes the various situations in which automatic creation of FHIR Communication (ehealth-message) takes place. In the table, the columns following the naming pattern Element <some element name> describe what values must be used in a corresponding CommunicationRequest in order to control creation.

To apply for FHIR Communication with the Patient as recipient, add the following to the CommunicationRequest:

• recipient = Patient reference

• category = <depending on situation>

• reasonCode = <depending on situation>

• episodeOfCare = <depending on situation>

• basedOn = <depending on situation>

• priority = <depending on situation>

Controlling Creation of Message with CareTeam as Recipient

The table below describes the various situations in which automatic creation of FHIR Communication (ehealth-message) takes place. In the table, the columns following the naming pattern Element <some element name> describe what values must be used in a corresponding CommunicationRequest in order to control creation.

To apply for FHIR Communication with a CareTeam as recipient, add the following to the CommunicationRequest:

• recipient = CareTeam reference

• category = <depending on situation>

• reasonCode = <depending on situation>

• episodeOfCare = <depending on situation>

• basedOn = <depending on situation>

• priority = <depending on situation>

Overriding the Payload and/or Medium

Example of CommunicationRequest for overriding payload and medium (adding NemSMS). For overriding default NemSMS medium, simply leave medium in CommunicationRequest empty.

{
	"resourceType": "CommunicationRequest",
	"meta": {
		"profile": [
			"http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-request"
		]
	},
	"extension": [
		{
			"url": "http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare",
			"valueReference": {
				"reference": "https://careplan.local.ehealth.sundhed.dk/fhir/EpisodeOfCare/12992"
			}
		}
	],
	"basedOn": [
		{
			"reference": "https://careplan.local.ehealth.sundhed.dk/fhir/ServiceRequest/67410"
		}
	],
	"status": "active",
	"doNotPerform": false,
	"medium": [
		{
			"coding": [
				{
					"system": "http://ehealth.sundhed.dk/cs/message-medium",
					"code": "nemsms",
					"display": "NemSMS"
				}
			]
		}
	],
	"payload": [
		{
			"contentString": "Payload override"
		}
	],
	"subject": {
		"reference": "https://patient.local.ehealth.sundhed.dk/fhir/Patient/4093"
	},
	"occurrencePeriod": {
		"start": "2023-01-04T13:02:55+01:00"
	},
	"recipient": [
		{
			"reference": "https://organization.local.ehealth.sundhed.dk/fhir/CareTeam/40365"
		}
	],
	"reasonCode": [
		{
			"coding": [
				{
					"system": "http://ehealth.sundhed.dk/cs/task-category",
					"code": "UnexpectedMeasurementResolving",
					"display": "Need resolving of why unexpected measurement was submitted"
				}
			]
		}
	]
}

Ending a Control of Message Creation

To remove the effect of a CommunicationRequest, perform a CommunicationRequest Update and set the status to completed. If the CommunicationRequest uses occurrencePeriod and has no occurrencePeriod.end, it would be consistent to set it to time of completing the CommunicationRequest.