OrganizationAffiliation — detail: networks & partnerships
Partnership agreement between two Organizations: a French GHT, an American ACO, a care network. Pivot of federated multi-organisation directories.
Role of inter-organisational agreements
Where Organization.partOf describes a strict hierarchical link (daughter entity), OrganizationAffiliation describes a horizontal agreement:
- French GHT: territorial hospital grouping with shared resources.
- US ACO: Accountable Care Organization with financial risk sharing.
- Care network: selective agreements between payer and facilities.
- Residency rotation / training agreement.
Key fields
| Field | Cardinality | Role |
|---|---|---|
organization | 0..1 | Host Organization. |
participatingOrganization | 0..1 | Guest Organization. |
code | 0..* | Role (member, agency, employer, payer, supplier...). |
specialty | 0..* | Delegated specialties. |
location | 0..* | Shared locations. |
healthcareService | 0..* | Shared services. |
endpoint | 0..* | Shared technical endpoints. |
period | 0..1 | Validity period of the agreement. |
Usage pattern
Always use OrganizationAffiliation for horizontal agreements; do not overload
Organization.partOf (which describes the internal structure).
Example: French GHT
{
"resourceType": "OrganizationAffiliation",
"id": "ght-essonne-affiliation-001",
"active": true,
"period": { "start": "2024-01-01" },
"organization": { "reference": "Organization/ch-corbeil" },
"participatingOrganization": { "reference": "Organization/ght-essonne-nord" },
"code": [{
"coding": [{
"system": "http://terminology.hl7.org/CodeSystem/organization-role",
"code": "member",
"display": "Member"
}]
}],
"specialty": [{
"coding": [{ "system": "http://snomed.info/sct", "code": "394579002", "display": "Cardiology" }]
}, {
"coding": [{ "system": "http://snomed.info/sct", "code": "394914008", "display": "Radiology" }]
}],
"location": [{ "reference": "Location/plateau-imagerie-mutualise" }],
"healthcareService": [{ "reference": "HealthcareService/teleradiologie-ght" }],
"endpoint": [{ "reference": "Endpoint/ght-pacs-shared" }]
}Common pitfalls
- No period — an agreement without
period.startis ambiguous: since when? forever? - Generic code — prefer a precise code (member, agency, payer) to free text.
- Confusion with PractitionerRole — OrganizationAffiliation = Org-to-Org; PractitionerRole = Practitioner-to-Org.