PACIO Advance Directive Interoperability Implementation Guide
0.1.0 - STU 1 Ballot

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## Resource Profile: PADIHeader - Detailed Descriptions

Definitions for the PADI-Header resource profile.

1. Composition
Definition | A set of healthcare-related information that is assembled together into a single logical package that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle where Bundle.type=document, and any other resources referenced from Composition must be included as subsequent entries in the Bundle (for example Patient, Practitioner, Encounter, etc.).
Control | 0..*
Comments | While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.
Invariants | Defined on this element dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (: text.`div`.exists())
2. Composition.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Control | 0..1
Type | string
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
3. Composition.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Control | 0..1
Type | Meta
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. Composition.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Control | 0..1
Type | uri
Is Modifier | true
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
5. Composition.language
Definition | The base language in which the resource is written.
Control | 1..1
Binding | The codes SHOULD be taken from CommonLanguages Max Binding: AllLanguages A human language.
Type | code
Must Support | true
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. Composition.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1
Type | Narrative
Alternate Names | narrative, html, xhtml, display
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. Composition.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Control | 0..*
Type | Resource
Alternate Names | inline resources, anonymous resources, contained resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
8. Composition.extension
Definition | An Extension
Control | 0..*
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on Composition.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
9. Composition.extension:versionNumber
SliceName | versionNumber
Definition | Version specific identifier for the composition, assigned when each version is created/updated.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(versionNumber) (Extension Type: string)
Comments | While each resource, including the composition itself, has its own version identifier, this is a formal identifier for the logical version of the composition as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. Composition.extension:VersionNumber
SliceName | VersionNumber
Definition | Advance Directive Information VersionNumber Extension represents a numeric value used to version successive replacement documents.
Control | 0..1
Type | Extension(VersionNumber) (Extension Type: integer)
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
11. Composition.extension:EffectiveDateExtension
SliceName | EffectiveDateExtension
Definition | The Advance Directive document effective dates.
Control | 0..1
Type | Extension(EffectiveDateExtension) (Extension Type: Period)
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
12. Composition.extension:Jurisdiction
SliceName | Jurisdiction
Definition | Jurisdiction for which content is applicable.
Control | 0..*
Type | Extension(Jurisdiction) (Extension Type: CodeableConcept)
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
13. Composition.extension:DataEntererExtension
SliceName | DataEntererExtension
Definition | Data Enterer Extension represents the person who transferred the content, written or dictated, into the Advance Directive document. To clarify, an author provides the content, subject to their own interpretation; a dataEnterer adds an author’s information to the electronic system.
Control | 0..1
Type | Extension(DataEntererExtension) (Extension Type: Reference)
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
14. Composition.extension:InformatExtension
SliceName | InformatExtension
Definition | The Advance Directive Information Informant Extension describes an information source for any content within the Advance Directive document. This informant is constrained for use when the source of information is an assigned health care provider for the patient.
Control | 0..*
Type | Extension(InformantExtension) (Extension Type: Reference)
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
15. Composition.extension:InformationRecipientExtension
SliceName | InformationRecipientExtension
Definition | The Information Recipient Extension records the intended recipient of the advance directive information at the time the document was created.
Control | 0..*
Type | Extension(InformationRecipientExtension) (Extension Type: Reference)
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
16. Composition.extension:ParticipantExtension
SliceName | ParticipantExtension
Definition | The Advance Directive Information Participant Extension identifies supporting entities, including parents, relatives, caregivers, insurance policyholders, guarantors, and others related in some way to the patient. A supporting person or organization is an individual or an organization with a relationship to the patient. A supporting person who is playing multiple roles would be recorded in multiple participants (e.g., emergency contact and next-of-kin).
Control | 0..*
Type | Extension(ParticipantExtension) (Extension Type: Reference)
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
17. Composition.extension:PerformerExtension
SliceName | PerformerExtension
Definition | The Advance Directive Information Performer Extension represents clinicians who actually and principally carry out the clinical services being documented. In a transfer of care this represents the healthcare providers involved in the current or pertinent historical care of the patient. Preferably, the patients key healthcare care team members would be listed, particularly their primary physician and any active consulting physicians, therapists, and counselors.
Control | 0..*
Type | Extension(PerformerExtension) (Extension Type: Reference)
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
18. Composition.extension:AuthorizationExtension
SliceName | AuthorizationExtension
Definition | The Advance Directive Information Authorization Extension contains the ADI Consent profile which represents information about a patient’s consents.
Control | 0..*
Type | Extension(AuthorizationExtension) (Extension Type: Reference)
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
19. Composition.extension:ClauseExtension
SliceName | ClauseExtension
Definition | A clause or set of clauses relevant to the resource or element being extended
Control | 0..*
Type | Extension(ClauseExtension) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
20. Composition.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
21. Composition.identifier
Definition | A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..1
Type | Identifier
Must Support | true
Comments | Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. Composition.status
Definition | The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.
Control | 1..1
Binding | The codes SHALL be taken from CompositionStatus The workflow/clinical status of the composition.
Type | code
Is Modifier | true
Requirements | Need to be able to mark interim, amended, or withdrawn compositions or documents.
Comments | If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements. Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
23. Composition.type
Definition | Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.
Control | 1..1
Binding | The codes SHALL be taken from Advance Directive Categories; other codes may be used where these codes are not suitable
Type | CodeableConcept
Must Support | true
Requirements | Key metadata element describing the composition, used in searching/filtering.
Comments | For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
24. Composition.category
Definition | A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.
Control | 1..1
Binding | For example codes, see DocumentClassValueSet High-level kind of a clinical document at a macro level.
Type | CodeableConcept
Must Support | true
Requirements | Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.
Comments | This is a metadata field from XDS/MHD.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
25. Composition.subject
Definition | Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).
Control | 1..1
Type | Reference(USCorePatientProfile)
Must Support | true
Requirements | Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.
Comments | For clinical documents, this is usually the patient.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
26. Composition.encounter
Definition | Describes the clinical encounter or type of care this documentation is associated with.
Control | 0..1
Type | Reference(USCoreEncounterProfile)
Must Support | true
Requirements | Provides context for the composition and supports searching.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
27. Composition.date
Definition | The composition editing time, when the composition was last logically changed by the author.
Control | 1..1
Type | dateTime
Must Support | true
Requirements | dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.
Comments | The Last Modified Date on the composition may be after the date of the document was attested without being changed.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
28. Composition.author
Definition | Identifies who is responsible for the information in the composition, not necessarily who typed it in.
Control | 1..*
Type | Reference(USCorePractitionerProfile | USCorePractitionerRoleProfile | PractitionerRole | USCorePatientProfile | Device | RelatedPerson)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
29. Composition.title
Definition | Official human-readable label for the composition.
Control | 1..1
Type | string
Must Support | true
Comments | For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
30. Composition.confidentiality
Definition | The code specifying the level of confidentiality of the Composition.
Control | 0..0
Binding | The codes SHALL be taken from v3.ConfidentialityClassification (2014-03-26) Codes specifying the level of confidentiality of the composition.
Type | code
Comments | The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
31. Composition.attester
Definition | A participant who has attested to the accuracy of the composition/document.
Control | 0..*
Type | BackboneElement
Requirements | Identifies responsibility for the accuracy of the composition content.
Comments | Only list each attester once.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Composition.attester. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ mode
32. Composition.attester.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
33. Composition.attester.extension
Definition | An Extension
Control | 1..*
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on Composition.attester.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
34. Composition.attester.extension:AttestationInformationExtension
SliceName | AttestationInformationExtension
Definition | The Attestation Information Extension allows for the capture of information relevant to the attestation.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(AttestationInformationExtension) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) notary-information-requires-notary-role: If Notary information (seal or commission expiration date exists, then role must be notary (: (extension.where(url = 'NotarySealId').valuerIdentifier.exists() or extension.where(url = 'NotaryCommissionExpirationDate').valueDate.exists()) implies extension.where(url = 'AttesterRole').valueCodeableConcept.where(coding.code='81372-5').exists())
35. Composition.attester.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
36. Composition.attester.mode
Definition | The type of attestation the authenticator offers.
Control | 1..1
Binding | The codes SHALL be taken from CompositionAttestationMode The way in which a person authenticated a composition.
Type | code
Requirements | Indicates the level of authority of the attestation.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
37. Composition.attester.time
Definition | When the composition was attested by the party.
Control | 0..1
Type | dateTime
Requirements | Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
38. Composition.attester.party
Definition | Who attested the composition in the specified way.
Control | 0..1
Type | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization)
Requirements | Identifies who has taken on the responsibility for accuracy of the composition content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
39. Composition.attester:legal_attester
SliceName | legal_attester
Definition | A participant who has attested to the accuracy of the composition/document.
Control | 0..1
Type | BackboneElement
Must Support | true
Requirements | Identifies responsibility for the accuracy of the composition content.
Comments | Only list each attester once.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
40. Composition.attester:legal_attester.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
41. Composition.attester:legal_attester.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
42. Composition.attester:legal_attester.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
43. Composition.attester:legal_attester.mode
Definition | The type of attestation the authenticator offers.
Control | 1..1
Binding | The codes SHALL be taken from CompositionAttestationMode The way in which a person authenticated a composition.
Type | code
Must Support | true
Requirements | Indicates the level of authority of the attestation.
Pattern Value | legal
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
44. Composition.attester:legal_attester.time
Definition | When the composition was attested by the party.
Control | 0..1
Type | dateTime
Requirements | Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
45. Composition.attester:legal_attester.party
Definition | Who attested the composition in the specified way.
Control | 1..1
Type | Reference(USCorePractitionerProfile | USCorePractitionerRoleProfile | RelatedPerson | USCoreOrganizationProfile)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Requirements | Identifies who has taken on the responsibility for accuracy of the composition content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
46. Composition.attester:notary_attester
SliceName | notary_attester
Definition | A participant who has attested to the accuracy of the composition/document.
Control | 0..*
Type | BackboneElement
Must Support | true
Requirements | Identifies responsibility for the accuracy of the composition content.
Comments | Only list each attester once.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
47. Composition.attester:notary_attester.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
48. Composition.attester:notary_attester.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
49. Composition.attester:notary_attester.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
50. Composition.attester:notary_attester.mode
Definition | The type of attestation the authenticator offers.
Control | 1..1
Binding | The codes SHALL be taken from CompositionAttestationMode The way in which a person authenticated a composition.
Type | code
Must Support | true
Requirements | Indicates the level of authority of the attestation.
Pattern Value | professional
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
51. Composition.attester:notary_attester.time
Definition | When the composition was attested by the party.
Control | 0..1
Type | dateTime
Requirements | Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
52. Composition.attester:notary_attester.party
Definition | Who attested the composition in the specified way.
Control | 1..1
Type | Reference(RelatedPerson)
Must Support | true
Requirements | Identifies who has taken on the responsibility for accuracy of the composition content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
53. Composition.attester:witness_attester
SliceName | witness_attester
Definition | A participant who has attested to the accuracy of the composition/document.
Control | 0..*
Type | BackboneElement
Must Support | true
Requirements | Identifies responsibility for the accuracy of the composition content.
Comments | Only list each attester once.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
54. Composition.attester:witness_attester.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
55. Composition.attester:witness_attester.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
56. Composition.attester:witness_attester.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
57. Composition.attester:witness_attester.mode
Definition | The type of attestation the authenticator offers.
Control | 1..1
Binding | The codes SHALL be taken from CompositionAttestationMode The way in which a person authenticated a composition.
Type | code
Must Support | true
Requirements | Indicates the level of authority of the attestation.
Pattern Value | personal
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
58. Composition.attester:witness_attester.time
Definition | When the composition was attested by the party.
Control | 0..1
Type | dateTime
Requirements | Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
59. Composition.attester:witness_attester.party
Definition | Who attested the composition in the specified way.
Control | 1..1
Type | Reference(USCorePatientProfile | RelatedPerson)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Requirements | Identifies who has taken on the responsibility for accuracy of the composition content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
60. Composition.custodian
Definition | Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.
Control | 1..1
Type | Reference(USCoreOrganizationProfile)
Must Support | true
Requirements | Identifies where to go to find the current version, where to report issues, etc.
Comments | This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
61. Composition.relatesTo
Definition | Relationships that this composition has with other compositions or documents that already exist.
Control | 0..*
Type | BackboneElement
Comments | A document is a version specific composition.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
62. Composition.relatesTo.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
63. Composition.relatesTo.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
64. Composition.relatesTo.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
65. Composition.relatesTo.code
Definition | The type of relationship that this composition has with anther composition or document.
Control | 1..1
Binding | The codes SHALL be taken from DocumentRelationshipType The type of relationship between documents.
Type | code
Comments | If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
66. Composition.relatesTo.target[x]
Definition | The target composition/document of this relationship.
Control | 1..1
Type | Choice of: Identifier, Reference(Composition)
[x] Note | See Choice of Data Types for further information about how to use [x]
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
67. Composition.event
Definition | The clinical service, such as a colonoscopy or an appendectomy, being documented.
Control | 0..*
Type | BackboneElement
Requirements | Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.
Comments | The event needs to be consistent with the type element, though can provide further information if desired.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
68. Composition.event.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
69. Composition.event.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
70. Composition.event.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
71. Composition.event.code
Definition | This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.
Control | 0..*
Binding | For example codes, see v3 Code System ActCode This list of codes represents the main clinical acts being documented.
Type | CodeableConcept
Comments | An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
72. Composition.event.period
Definition | The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.
Control | 0..1
Type | Period
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
73. Composition.event.detail
Definition | The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.
Control | 0..*
Type | Reference(Resource)
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
74. Composition.section
Definition | The root of the sections that make up the composition.
Control | 0..*
Type | BackboneElement
Invariants | Defined on this element cmp-1: A section must contain at least one of text, entries, or sub-sections (: text.exists() or entry.exists() or section.exists()) cmp-2: A section can only have an emptyReason if it is empty (: emptyReason.empty() or entry.empty()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
75. Composition.section.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
76. Composition.section.extension
Definition | An Extension
Control | 0..*
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on Composition.section.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
77. Composition.section.extension:ClauseExtension
SliceName | ClauseExtension
Definition | A clause or set of clauses relevant to the resource or element being extended
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(ClauseExtension) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
78. Composition.section.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
79. Composition.section.title
Definition | The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
Control | 0..1
Type | string
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Comments | The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
80. Composition.section.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Control | 0..1
Binding | For example codes, see DocumentSectionCodes Classification of a section of a composition/document.
Type | CodeableConcept
Requirements | Provides computable standardized labels to topics within the document.
Comments | The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
81. Composition.section.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Control | 0..*
Type | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
Requirements | Identifies who is responsible for the content.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
82. Composition.section.focus
Definition | The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Control | 0..1
Type | Reference(Resource)
Comments | Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
83. Composition.section.text
Definition | A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Control | 0..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
84. Composition.section.mode
Definition | How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
Control | 0..1
Binding | The codes SHALL be taken from ListMode The processing mode that applies to this section.
Type | code
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
85. Composition.section.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes What order applies to the items in the entry.
Type | CodeableConcept
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
86. Composition.section.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
87. Composition.section.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons If a section is empty, why it is empty.
Type | CodeableConcept
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Comments | The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
88. Composition.section.section
Definition | A nested sub-section within this section.
Control | 0..* This element is affected by the following invariants: cmp-1
Type | See ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))