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<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="profile-DwComposition" />
  <url value="https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwComposition" />
  <name value="DwComposition" />
  <status value="draft" />
  <date value="2024-05-03T22:11:40.4165223+00:00" />
  <fhirVersion value="4.0.1" />
  <kind value="resource" />
  <abstract value="false" />
  <type value="Composition" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Composition" />
  <derivation value="constraint" />
  <differential>
    <element id="Composition.meta">
      <path value="Composition.meta" />
    </element>
    <element id="Composition.meta.lastUpdated">
      <path value="Composition.meta.lastUpdated" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.meta.source">
      <path value="Composition.meta.source" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.meta.security">
      <path value="Composition.meta.security" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.text">
      <path value="Composition.text" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.extension">
      <path value="Composition.extension" />
      <mustSupport value="false" />
    </element>
    <element id="Composition.extension:versionNumber">
      <path value="Composition.extension" />
      <sliceName value="versionNumber" />
      <type>
        <code value="Extension" />
        <profile value="http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber" />
      </type>
      <mustSupport value="true" />
      <isModifier value="false" />
    </element>
    <element id="Composition.identifier">
      <path value="Composition.identifier" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.status">
      <path value="Composition.status" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.type">
      <path value="Composition.type" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.type.coding">
      <path value="Composition.type.coding" />
      <fixedCoding>
        <system value="http://loinc.org" />
        <code value="60591-5" />
        <display value="Patient summary Document" />
      </fixedCoding>
      <binding>
        <strength value="preferred" />
        <valueSet value="http://loinc.org" />
      </binding>
    </element>
    <element id="Composition.subject">
      <path value="Composition.subject" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.date">
      <path value="Composition.date" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.author">
      <path value="Composition.author" />
      <comment value="Usage Note: Provide Reference to Organization&#xD;&#xA;&#xD;&#xA;References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
      <mustSupport value="true" />
    </element>
    <element id="Composition.title">
      <path value="Composition.title" />
      <comment value="Usage Note:  CA Patient Summary&#xD;&#xA;&#xD;&#xA;For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a &quot;consultation&quot; or &quot;progress note&quot;). 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." />
      <mustSupport value="true" />
    </element>
    <element id="Composition.attester">
      <path value="Composition.attester" />
      <comment value="Usage Note: for future developent when the composition is manually reviewed/created by  the patient/related person/provider/organization&#xD;&#xA;&#xD;&#xA;Only list each attester once." />
      <mustSupport value="true" />
    </element>
    <element id="Composition.attester.mode">
      <path value="Composition.attester.mode" />
      <fixedCode value="legal" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.custodian">
      <path value="Composition.custodian" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.event">
      <path value="Composition.event" />
      <label value="careProvisioningEvent" />
      <slicing>
        <discriminator>
          <type value="type" />
          <path value="$this" />
        </discriminator>
        <rules value="open" />
      </slicing>
      <short value="The care provisioning being documented" />
      <definition value="The provision of healthcare over a period of time this PS is documented." />
    </element>
    <element id="Composition.event:careProvisioningEvent">
      <path value="Composition.event" />
      <sliceName value="careProvisioningEvent" />
      <label value="careProvisioningEvent" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.event:careProvisioningEvent.code">
      <path value="Composition.event.code" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.event:careProvisioningEvent.code.coding">
      <path value="Composition.event.code.coding" />
      <code>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActClass" />
        <code value="PCPR" />
        <display value="care provision" />
      </code>
      <mustSupport value="true" />
    </element>
    <element id="Composition.event:careProvisioningEvent.code.coding.system">
      <path value="Composition.event.code.coding.system" />
      <mustSupport value="true" />
      <binding>
        <strength value="required" />
        <valueSet value="http://terminology.hl7.org/CodeSystem/v3-ActClass" />
      </binding>
    </element>
    <element id="Composition.event:careProvisioningEvent.code.coding.code">
      <path value="Composition.event.code.coding.code" />
      <fixedCode value="PCPR" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.event:careProvisioningEvent.period">
      <path value="Composition.event.period" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.event:careProvisioningEvent.period.start">
      <path value="Composition.event.period.start" />
      <comment value="Earliest entry in the composition&#xD;&#xA;&#xD;&#xA;If the low element is missing, the meaning is that the low boundary is not known." />
    </element>
    <element id="Composition.event:careProvisioningEvent.period.end">
      <path value="Composition.event.period.end" />
      <comment value="Latest entry in the composition. &#xD;&#xA;The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03." />
    </element>
    <element id="Composition.section">
      <path value="Composition.section" />
      <slicing>
        <discriminator>
          <type value="type" />
          <path value="$this" />
        </discriminator>
        <rules value="open" />
      </slicing>
    </element>
    <element id="Composition.section:sectionMedications">
      <path value="Composition.section" />
      <sliceName value="sectionMedications" />
      <short value="Medication Summary Section" />
      <definition value="The medication summary section contains a description of the patient's medications relevant for the scope of the patient summary. The actual content could depend on the jurisdiction, it could report:&#xD;&#xA;&#xD;&#xA;the currently active medications;&#xD;&#xA;the current and past medications considered relevant by the authoring GP;&#xD;&#xA;the patient prescriptions or dispensations automatically extracted by a regional or a national EHR.&#xD;&#xA;Because This section has been expanded in the PS-CA to model a medicationRequest profile in addition to medicationStatement profile initially included in IPS-UV. This section requires either an entry indicating the subject is known not to be on any relevant medication; either an entry indicating that no information is available about medications; or entries summarizing the subject's relevant medications." />
      <comment value="IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of entry. This constraint has been maintainted in the PS-CA. Systems that can support the clinical profiles in this section that do not have content for a given patient should use the absent/unknown pattern in the clinical profile. Systems that wholistically cannot produce the referenced profiles should use the new content not supported profile to communicate the system limitation. This pattern is considered a temporary measure to allow for patient summaries to be exchanged in Canada (and internationally) while some systems work to meet the expectations for the full set of patient summary sections." />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionMedications.title">
      <path value="Composition.section.title" />
      <label value="Medication Summary" />
      <min value="1" />
      <fixedString value="Medication" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionMedications.code">
      <path value="Composition.section.code" />
      <min value="1" />
      <mustSupport value="true" />
      <binding>
        <strength value="preferred" />
      </binding>
    </element>
    <element id="Composition.section:sectionMedications.code.coding">
      <path value="Composition.section.code.coding" />
      <code>
        <system value="http://loinc.org" />
        <code value="10160-0" />
        <display value="Hx of Medication use" />
      </code>
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionMedications.code.coding.system">
      <path value="Composition.section.code.coding.system" />
      <mustSupport value="true" />
      <binding>
        <strength value="required" />
        <valueSet value="http://loinc.org" />
      </binding>
    </element>
    <element id="Composition.section:sectionMedications.code.coding.code">
      <path value="Composition.section.code.coding.code" />
      <code>
        <system value="http://loinc.org" />
        <code value="10160-0" />
        <display value="Hx of Medication Use" />
      </code>
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionMedications.code.coding.display">
      <path value="Composition.section.code.coding.display" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionMedications.text">
      <path value="Composition.section.text" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionMedications.entry">
      <path value="Composition.section.entry" />
      <slicing>
        <discriminator>
          <type value="type" />
          <path value="$this" />
        </discriminator>
        <rules value="open" />
      </slicing>
      <comment value="This entry requires a medicationStatement, a medicationRequest, or population of a resource according to the MedicationSectionNotSupported profile. If there are no entries in the list, an emptyReason SHOULD be provided." />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionMedications.entry:medicationStatement">
      <path value="Composition.section.entry" />
      <sliceName value="medicationStatement" />
      <short value="Medication statements relevant for the scope of the patient summary" />
      <definition value="This Medication Statements relevant for the scope of the patient summary or it is used to indicate that the subject is known not to be on any relevant medication; either that no information is available about medications." />
    </element>
    <element id="Composition.section:sectionMedications.entry:medicationRequest">
      <path value="Composition.section.entry" />
      <sliceName value="medicationRequest" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionMedications.emptyReason">
      <path value="Composition.section.emptyReason" />
      <max value="0" />
    </element>
    <element id="Composition.section:sectionMedications.section">
      <path value="Composition.section.section" />
      <max value="0" />
    </element>
    <element id="Composition.section:sectionAllergies">
      <path value="Composition.section" />
      <sliceName value="sectionAllergies" />
      <short value="Allergies and Intolerances Section" />
      <definition value="This section documents the relevant allergies or intolerances (conditions) for that patient, describing the kind of reaction (e.g. rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. If no information about allergies is available, or if no allergies are known this should be clearly documented in the section." />
      <comment value="IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of entry. This constraint has been maintainted in the PS-CA. Systems that can support the clinical profiles in this section that do not have content for a given patient should use the absent/unknown pattern in the clinical profile. Systems that wholistically cannot produce the referenced profiles should use the new content not supported profile to communicate the system limitation. This pattern is considered a temporary measure to allow for patient summaries to be exchanged in Canada (and internationally) while some systems work to meet the expectations for the full set of patient summary sections." />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionAllergies.title">
      <path value="Composition.section.title" />
      <label value="Allergies and Intolerances" />
      <short value="Allergies and Intolerances" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionAllergies.code">
      <path value="Composition.section.code" />
      <code>
        <system value="http://loinc.org" />
        <code value="48765-2" />
        <display value="Allergy &amp;or Adverse Reactions document" />
      </code>
      <min value="1" />
      <mustSupport value="true" />
      <binding>
        <strength value="preferred" />
        <valueSet value="http://loinc.org" />
      </binding>
    </element>
    <element id="Composition.section:sectionAllergies.code.coding">
      <path value="Composition.section.code.coding" />
      <code>
        <system value="http://loinc.org" />
        <code value="48765-2" />
        <display value="Allergies and Adverse reactions Document" />
      </code>
      <mustSupport value="true" />
      <binding>
        <strength value="required" />
        <valueSet value="http://loinc.org" />
      </binding>
    </element>
    <element id="Composition.section:sectionAllergies.code.coding.system">
      <path value="Composition.section.code.coding.system" />
      <mustSupport value="true" />
      <binding>
        <strength value="required" />
        <valueSet value="http://loinc.org" />
      </binding>
    </element>
    <element id="Composition.section:sectionAllergies.code.coding.code">
      <path value="Composition.section.code.coding.code" />
      <fixedCode value="48765-2" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionAllergies.code.coding.display">
      <path value="Composition.section.code.coding.display" />
      <fixedString value="Allergies and Adverse reactions Document" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionAllergies.text">
      <path value="Composition.section.text" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionAllergies.entry">
      <path value="Composition.section.entry" />
      <slicing>
        <discriminator>
          <type value="type" />
          <path value="$this" />
        </discriminator>
        <rules value="open" />
      </slicing>
      <min value="1" />
    </element>
    <element id="Composition.section:sectionAllergies.entry:allergyOrIntolerance">
      <path value="Composition.section.entry" />
      <sliceName value="allergyOrIntolerance" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionAllergies.emptyReason">
      <path value="Composition.section.emptyReason" />
      <max value="0" />
    </element>
    <element id="Composition.section:sectionAllergies.section">
      <path value="Composition.section.section" />
      <max value="0" />
    </element>
    <element id="Composition.section:sectionProblems">
      <path value="Composition.section" />
      <sliceName value="sectionProblems" />
      <short value="Problems section" />
      <definition value="The PS problem section lists and describes clinical problems or conditions currently being monitored for the patient." />
      <comment value="IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of entry. This constraint has been maintainted in the PS-CA. Systems that can support the clinical profiles in this section that do not have content for a given patient should use the absent/unknown pattern in the clinical profile. Systems that wholistically cannot produce the referenced profiles should use the new content not supported profile to communicate the system limitation. This pattern is considered a temporary measure to allow for patient summaries to be exchanged in Canada (and internationally) while some systems work to meet the expectations for the full set of patient summary sections." />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionProblems.title">
      <path value="Composition.section.title" />
      <label value="Problems List" />
      <min value="1" />
      <fixedString value="Active Problems" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionProblems.code">
      <path value="Composition.section.code" />
      <code>
        <system value="http://loinc.org" />
        <code value="11450-4" />
        <display value="Problem List - Reported" />
      </code>
      <min value="1" />
      <mustSupport value="true" />
      <binding>
        <strength value="required" />
        <valueSet value="http://loinc.org" />
      </binding>
    </element>
    <element id="Composition.section:sectionProblems.code.coding">
      <path value="Composition.section.code.coding" />
      <code>
        <system value="http://loinc.org" />
        <code value="11450-4" />
        <display value="Problem List - Reported" />
      </code>
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionProblems.code.coding.system">
      <path value="Composition.section.code.coding.system" />
      <mustSupport value="true" />
      <binding>
        <strength value="required" />
        <valueSet value="http://loinc.org" />
      </binding>
    </element>
    <element id="Composition.section:sectionProblems.code.coding.code">
      <path value="Composition.section.code.coding.code" />
      <fixedCode value="11450-4" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionProblems.code.coding.display">
      <path value="Composition.section.code.coding.display" />
      <fixedString value="Problem List - Reported" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionProblems.text">
      <path value="Composition.section.text" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionProblems.entry">
      <path value="Composition.section.entry" />
      <slicing>
        <discriminator>
          <type value="type" />
          <path value="$this" />
        </discriminator>
        <rules value="open" />
      </slicing>
      <min value="1" />
    </element>
    <element id="Composition.section:sectionProblems.entry:problem">
      <path value="Composition.section.entry" />
      <sliceName value="problem" />
    </element>
    <element id="Composition.section:sectionProblems.emptyReason">
      <path value="Composition.section.emptyReason" />
      <max value="0" />
    </element>
    <element id="Composition.section:sectionProblems.section">
      <path value="Composition.section.section" />
      <max value="0" />
    </element>
    <element id="Composition.section:sectionProceduresHx">
      <path value="Composition.section" />
      <sliceName value="sectionProceduresHx" />
      <short value="History of Procedures Section" />
      <definition value="The History of Procedures Section contains a description of the patient past procedures that are pertinent to the scope of this document. Procedures may refer for example to:&#xD;&#xA;&#xD;&#xA;Invasive Diagnostic procedure:e.g. Cardiac catheterization; (the results of these procedure are documented in the results section)&#xD;&#xA;Therapeutic procedure: e.g. dialysis;&#xD;&#xA;Surgical procedure: e.g. appendectomy" />
      <comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionProceduresHx.title">
      <path value="Composition.section.title" />
      <label value="History of Procedures" />
      <min value="1" />
      <fixedString value="History of Procedures" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionProceduresHx.code">
      <path value="Composition.section.code" />
      <code>
        <system value="http://loinc.org" />
        <code value="47519-4" />
        <display value="History of Procedures document" />
      </code>
      <min value="1" />
      <mustSupport value="true" />
      <binding>
        <strength value="preferred" />
        <valueSet value="http://loinc.org" />
      </binding>
    </element>
    <element id="Composition.section:sectionProceduresHx.code.coding">
      <path value="Composition.section.code.coding" />
      <code>
        <system value="http://loinc.org" />
        <code value="47519-4" />
        <display value="History of Procedures document" />
      </code>
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionProceduresHx.code.coding.system">
      <path value="Composition.section.code.coding.system" />
      <code>
        <system value="http://loinc.org" />
        <code value="47519-4" />
        <display value="History of Procedures Document" />
      </code>
      <fixedUri value="http://loinc.org" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionProceduresHx.code.coding.code">
      <path value="Composition.section.code.coding.code" />
      <fixedCode value="47519-4" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionProceduresHx.code.coding.display">
      <path value="Composition.section.code.coding.display" />
      <fixedString value="History of Procedures Document" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionProceduresHx.text">
      <path value="Composition.section.text" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionProceduresHx.entry">
      <path value="Composition.section.entry" />
      <slicing>
        <discriminator>
          <type value="type" />
          <path value="$this" />
        </discriminator>
        <rules value="open" />
      </slicing>
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionProceduresHx.entry:procedure">
      <path value="Composition.section.entry" />
      <sliceName value="procedure" />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionProceduresHx.emptyReason">
      <path value="Composition.section.emptyReason" />
      <max value="0" />
    </element>
    <element id="Composition.section:sectionProceduresHx.section">
      <path value="Composition.section.section" />
      <max value="0" />
    </element>
    <element id="Composition.section:sectionImmunizations">
      <path value="Composition.section" />
      <sliceName value="sectionImmunizations" />
      <short value="Immunizations Section" />
      <definition value="The Immunizations Section defines a patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. The section includes the current immunization status, and may contain the entire immunization history that is relevant to the period of time being summarized." />
      <comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionImmunizations.title">
      <path value="Composition.section.title" />
      <label value="History of Immunization" />
      <min value="1" />
      <fixedString value="History of Immunization" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionImmunizations.code">
      <path value="Composition.section.code" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Composition.section:sectionImmunizations.code.coding">
      <path value="Composition.section.code.coding" />
      <code>
        <system value="http://loinc.org" />
        <code value="11369-6" />
        <display value="History of Immunization Narrative" />
      </code>
      <mustSupport value="true" />
      <binding>
        <strength value="preferred" />
        <valueSet value="http://loinc.org" />
      </binding>
    </element>
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{

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