{
  "resourceType": "StructureDefinition",
  "id": "97509562-0326-459e-a863-430574146520",
  "url": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-CommunicationRequest",
  "name": "NHSDigitalCommunicationRequest",
  "status": "draft",
  "fhirVersion": "4.0.1",
  "mapping": [
    {
      "identity": "workflow",
      "uri": "http://hl7.org/fhir/workflow",
      "name": "Workflow Pattern"
    },
    {
      "identity": "rim",
      "uri": "http://hl7.org/v3",
      "name": "RIM Mapping"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "CommunicationRequest",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/CommunicationRequest",
  "derivation": "constraint",
  "snapshot": {
    "element": [
      {
        "id": "CommunicationRequest",
        "path": "CommunicationRequest",
        "short": "A request for information to be sent to a receiver",
        "definition": "A request to convey information; e.g. the CDS system proposes that an alert be sent to a responsible provider, the CDS system proposes that the public health agency be notified about a reportable condition.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "CommunicationRequest",
          "min": 0,
          "max": "*"
        },
        "constraint": [
          {
            "key": "dom-2",
            "severity": "error",
            "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
            "expression": "contained.contained.empty()",
            "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
          },
          {
            "key": "dom-4",
            "severity": "error",
            "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
            "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
            "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
          },
          {
            "key": "dom-3",
            "severity": "error",
            "human": "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",
            "expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
            "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
          },
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
                "valueBoolean": true
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
                "valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
              }
            ],
            "key": "dom-6",
            "severity": "warning",
            "human": "A resource should have narrative for robust management",
            "expression": "text.`div`.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
          },
          {
            "key": "dom-5",
            "severity": "error",
            "human": "If a resource is contained in another resource, it SHALL NOT have a security label",
            "expression": "contained.meta.security.empty()",
            "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "Entity. Role, or Act"
          },
          {
            "identity": "rim",
            "map": "Entity, Role, or Act"
          },
          {
            "identity": "workflow",
            "map": "Request"
          },
          {
            "identity": "w5",
            "map": "workflow.order"
          }
        ]
      },
      {
        "id": "CommunicationRequest.id",
        "path": "CommunicationRequest.id",
        "short": "Logical id of this artifact",
        "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
        "comment": "Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Resource.id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "id"
              }
            ],
            "code": "id"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "CommunicationRequest.meta",
        "path": "CommunicationRequest.meta",
        "short": "Metadata about the resource",
        "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.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Resource.meta",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Meta"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.implicitRules",
        "path": "CommunicationRequest.implicitRules",
        "short": "A set of rules under which this content was created",
        "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.",
        "comment": "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 its narrative along with other profiles, value sets, etc.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Resource.implicitRules",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "uri"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": false,
        "isModifier": true,
        "isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation",
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "CommunicationRequest.language",
        "path": "CommunicationRequest.language",
        "short": "Language of the resource content",
        "definition": "The base language in which the resource is written.",
        "comment": "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).",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Resource.language",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": false,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "Language"
            }
          ],
          "strength": "required",
          "description": "IETF language tag for a human language",
          "valueSet": "http://hl7.org/fhir/ValueSet/all-languages|5.0.0"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "CommunicationRequest.text",
        "path": "CommunicationRequest.text",
        "short": "Text summary of the resource, for human interpretation",
        "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.",
        "comment": "Contained resources do not have a 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.",
        "alias": [
          "narrative",
          "html",
          "xhtml",
          "display"
        ],
        "min": 0,
        "max": "1",
        "base": {
          "path": "DomainResource.text",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Narrative"
          }
        ],
        "condition": [
          "dom-6"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          },
          {
            "identity": "rim",
            "map": "Act.text?"
          }
        ]
      },
      {
        "id": "CommunicationRequest.contained",
        "path": "CommunicationRequest.contained",
        "short": "Contained, inline Resources",
        "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.",
        "comment": "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.",
        "alias": [
          "inline resources",
          "anonymous resources",
          "contained resources"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "DomainResource.contained",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Resource"
          }
        ],
        "condition": [
          "dom-2",
          "dom-4",
          "dom-3",
          "dom-5"
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "Entity. Role, or Act"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.extension",
        "path": "CommunicationRequest.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "description": "Extensions are always sliced by (at least) url",
          "rules": "open"
        },
        "short": "Additional content defined by implementations",
        "definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, 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.",
        "comment": "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "DomainResource.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.modifierExtension",
        "path": "CommunicationRequest.modifierExtension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "description": "Extensions are always sliced by (at least) url",
          "rules": "open"
        },
        "short": "Extensions that cannot be ignored",
        "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 managable, 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
        "comment": "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.",
        "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](extensibility.html#modifierExtension).",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "DomainResource.modifierExtension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "mustSupport": false,
        "isModifier": true,
        "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.identifier",
        "path": "CommunicationRequest.identifier",
        "short": "Unique identifier",
        "definition": "Business identifiers assigned to this communication request by the performer or other systems which remain constant as the resource is updated and propagates from server to server.",
        "comment": "This is a business identifier, not a resource identifier (see [discussion](resource.html#identifiers)).  It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types.  For example, multiple Patient and a Person resource instance might share the same social insurance number.",
        "requirements": "Allows identification of the communication request as it is known by various participating systems and in a way that remains consistent across servers.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "CommunicationRequest.identifier",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Identifier"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ident-1",
            "severity": "warning",
            "human": "Identifier with no value has limited utility.  If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason",
            "expression": "value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Identifier"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
          },
          {
            "identity": "rim",
            "map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]"
          },
          {
            "identity": "servd",
            "map": "Identifier"
          },
          {
            "identity": "workflow",
            "map": "Request.identifier"
          },
          {
            "identity": "w5",
            "map": "FiveWs.identifier"
          }
        ]
      },
      {
        "id": "CommunicationRequest.basedOn",
        "path": "CommunicationRequest.basedOn",
        "short": "Fulfills plan or proposal",
        "definition": "A plan or proposal that is fulfilled in whole or in part by this request.",
        "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.",
        "requirements": "Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon.",
        "alias": [
          "fulfills"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "CommunicationRequest.basedOn",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Resource"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ref-1",
            "severity": "error",
            "human": "SHALL have a contained resource if a local reference is provided",
            "expression": "reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          },
          {
            "key": "ref-2",
            "severity": "error",
            "human": "At least one of reference, identifier and display SHALL be present (unless an extension is provided).",
            "expression": "reference.exists() or identifier.exists() or display.exists() or extension.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
          },
          {
            "identity": "workflow",
            "map": "Request.basedOn"
          },
          {
            "identity": "rim",
            "map": ".outboundRelationship[typeCode=FLFS].target"
          }
        ]
      },
      {
        "id": "CommunicationRequest.replaces",
        "path": "CommunicationRequest.replaces",
        "short": "Request(s) replaced by this request",
        "definition": "Completed or terminated request(s) whose function is taken by this new request.",
        "comment": "The replacement could be because the initial request was immediately rejected (due to an issue) or because the previous request was completed, but the need for the action described by the request remains ongoing.",
        "requirements": "Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests.",
        "alias": [
          "supersedes",
          "prior"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "CommunicationRequest.replaces",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/CommunicationRequest"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ref-1",
            "severity": "error",
            "human": "SHALL have a contained resource if a local reference is provided",
            "expression": "reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          },
          {
            "key": "ref-2",
            "severity": "error",
            "human": "At least one of reference, identifier and display SHALL be present (unless an extension is provided).",
            "expression": "reference.exists() or identifier.exists() or display.exists() or extension.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
          },
          {
            "identity": "workflow",
            "map": "Request.replaces"
          },
          {
            "identity": "rim",
            "map": ".outboundRelationship[typeCode=RPLC].target"
          }
        ]
      },
      {
        "id": "CommunicationRequest.groupIdentifier",
        "path": "CommunicationRequest.groupIdentifier",
        "short": "Composite request this is part of",
        "definition": "A shared identifier common to multiple independent Request instances that were activated/authorized more or less simultaneously by a single author.  The presence of the same identifier on each request ties those requests together and may have business ramifications in terms of reporting of results, billing, etc.  E.g. a requisition number shared by a set of lab tests ordered together, or a prescription number shared by all meds ordered at one time.",
        "comment": "Requests are linked either by a \"basedOn\" relationship (i.e. one request is fulfilling another) or by having a common requisition.  Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.",
        "alias": [
          "grouperId"
        ],
        "min": 0,
        "max": "1",
        "base": {
          "path": "CommunicationRequest.groupIdentifier",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Identifier"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ident-1",
            "severity": "warning",
            "human": "Identifier with no value has limited utility.  If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason",
            "expression": "value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Identifier"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
          },
          {
            "identity": "rim",
            "map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]"
          },
          {
            "identity": "servd",
            "map": "Identifier"
          },
          {
            "identity": "workflow",
            "map": "Request.groupIdentifier"
          },
          {
            "identity": "rim",
            "map": ".inboundRelationship(typeCode=COMP].source[moodCode=INT].identifier"
          }
        ]
      },
      {
        "id": "CommunicationRequest.status",
        "path": "CommunicationRequest.status",
        "short": "draft | active | on-hold | revoked | completed | entered-in-error | unknown",
        "definition": "The status of the proposal or order.",
        "comment": "Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size",
        "min": 1,
        "max": "1",
        "base": {
          "path": "CommunicationRequest.status",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": true,
        "isModifierReason": "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid.",
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "CommunicationRequestStatus"
            }
          ],
          "strength": "required",
          "description": "The status of the communication request.",
          "valueSet": "http://hl7.org/fhir/ValueSet/request-status|5.0.0"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "workflow",
            "map": "Request.status"
          },
          {
            "identity": "w5",
            "map": "FiveWs.status"
          }
        ]
      },
      {
        "id": "CommunicationRequest.statusReason",
        "path": "CommunicationRequest.statusReason",
        "short": "Reason for current status",
        "definition": "Captures the reason for the current state of the CommunicationRequest.",
        "comment": "This is generally only used for \"exception\" statuses such as \"on-hold\" or \"revoked\".  The reason why the CommunicationRequest was created at all is captured in reasonCode, not here.",
        "alias": [
          "Suspended Reason",
          "Cancelled Reason"
        ],
        "min": 0,
        "max": "1",
        "base": {
          "path": "CommunicationRequest.statusReason",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": false,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "CommunicationRequestStatusReason"
            }
          ],
          "strength": "example",
          "description": "Codes identifying the reason for the current state of a request.",
          "valueSet": "http://hl7.org/fhir/ValueSet/communication-request-status-reason"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "CE/CNE/CWE"
          },
          {
            "identity": "rim",
            "map": "CD"
          },
          {
            "identity": "orim",
            "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
          },
          {
            "identity": "workflow",
            "map": "Request.statusReason"
          },
          {
            "identity": "rim",
            "map": ".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde"
          }
        ]
      },
      {
        "id": "CommunicationRequest.intent",
        "path": "CommunicationRequest.intent",
        "short": "proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option",
        "definition": "Indicates the level of authority/intentionality associated with the CommunicationRequest and where the request fits into the workflow chain.",
        "comment": "This element is expected to be immutable.  E.g. A \"proposal\" instance should never change to be a \"plan\" instance or \"order\" instance.  Instead, a new instance 'basedOn' the prior instance should be created with the new 'intent' value.\n\nOne exception to this is that the granularity of CommunicationRequest.intent is allowed to change.  For example, a Request identified as an \"order\" might later be clarified to be a \"filler-order\".  Or, in rarer cases (to meet recipient constraints), the reverse might also occur.",
        "requirements": "Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "CommunicationRequest.intent",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": false,
        "isModifier": true,
        "isModifierReason": "This element changes the interpretation of all descriptive attributes. For example \"the time the request is recommended to occur\" vs. \"the time the request is authorized to occur\" or \"who is recommended to perform the request\" vs. \"who is authorized to perform the request",
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "CommunicationRequestIntent"
            }
          ],
          "strength": "required",
          "description": "Codes indicating the degree of authority/intentionality associated with a request.",
          "valueSet": "http://hl7.org/fhir/ValueSet/request-intent|5.0.0"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "workflow",
            "map": "Request.intent"
          },
          {
            "identity": "w5",
            "map": "FiveWs.class"
          }
        ]
      },
      {
        "id": "CommunicationRequest.category",
        "path": "CommunicationRequest.category",
        "short": "Message category",
        "definition": "The type of message to be sent such as alert, notification, reminder, instruction, etc.",
        "comment": "There may be multiple axes of categorization and one communication request may serve multiple purposes.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "CommunicationRequest.category",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": false,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "CommunicationCategory"
            }
          ],
          "strength": "example",
          "description": "Codes for general categories of communications such as alerts, instruction, etc.",
          "valueSet": "http://hl7.org/fhir/ValueSet/communication-category"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "CE/CNE/CWE"
          },
          {
            "identity": "rim",
            "map": "CD"
          },
          {
            "identity": "orim",
            "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
          },
          {
            "identity": "w5",
            "map": "FiveWs.class"
          }
        ]
      },
      {
        "id": "CommunicationRequest.priority",
        "path": "CommunicationRequest.priority",
        "short": "routine | urgent | asap | stat",
        "definition": "Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routine.",
        "comment": "Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size",
        "min": 0,
        "max": "1",
        "base": {
          "path": "CommunicationRequest.priority",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ],
        "meaningWhenMissing": "If missing, this task should be performed with normal priority",
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "CommunicationPriority"
            }
          ],
          "strength": "required",
          "description": "Codes indicating the relative importance of a communication request.",
          "valueSet": "http://hl7.org/fhir/ValueSet/request-priority|5.0.0"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "workflow",
            "map": "Request.priority"
          },
          {
            "identity": "w5",
            "map": "FiveWs.grade"
          }
        ]
      },
      {
        "id": "CommunicationRequest.doNotPerform",
        "path": "CommunicationRequest.doNotPerform",
        "short": "True if request is prohibiting action",
        "definition": "If true indicates that the CommunicationRequest is asking for the specified action to *not* occur.",
        "comment": "The attributes provided with the request qualify what is not to be done.",
        "alias": [
          "prohibited"
        ],
        "min": 0,
        "max": "1",
        "base": {
          "path": "CommunicationRequest.doNotPerform",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "boolean"
          }
        ],
        "meaningWhenMissing": "If do not perform is not specified, the request is a positive request e.g. \"do perform\"",
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": false,
        "isModifier": true,
        "isModifierReason": "If true this element negates the specified action. For Example,  instead of a request for a communication, it is a request for the communication to not occur.",
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "workflow",
            "map": "Request.doNotPerform"
          }
        ]
      },
      {
        "id": "CommunicationRequest.medium",
        "path": "CommunicationRequest.medium",
        "short": "A channel of communication",
        "definition": "A channel that was used for this communication (e.g. email, fax).",
        "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "CommunicationRequest.medium",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": false,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "CommunicationMedium"
            }
          ],
          "strength": "extensible",
          "description": "Codes for communication mediums such as phone, fax, email, in person, etc.",
          "valueSet": "https://fhir.nhs.uk/ValueSet/Spine-CommunicationChannel-vs"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "CE/CNE/CWE"
          },
          {
            "identity": "rim",
            "map": "CD"
          },
          {
            "identity": "orim",
            "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
          }
        ]
      },
      {
        "id": "CommunicationRequest.subject",
        "path": "CommunicationRequest.subject",
        "short": "Focus of message",
        "definition": "The patient or group that is the focus of this communication request.\r\n\r\n```json\r\n\"subject\": {\r\n        \"type\": \"Patient\",\r\n        \"identifier\": {\r\n            \"system\": \"https://fhir.nhs.uk/Id/nhs-number\",\r\n            \"value\": \"9453740519\"\r\n        }\r\n    }\r\n```",
        "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.",
        "alias": [
          "patient"
        ],
        "min": 0,
        "max": "1",
        "base": {
          "path": "CommunicationRequest.subject",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ref-1",
            "severity": "error",
            "human": "SHALL have a contained resource if a local reference is provided",
            "expression": "reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          },
          {
            "key": "ref-2",
            "severity": "error",
            "human": "At least one of reference, identifier and display SHALL be present (unless an extension is provided).",
            "expression": "reference.exists() or identifier.exists() or display.exists() or extension.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          },
          {
            "key": "patient-reference",
            "severity": "warning",
            "human": "subject - An identifier reference plus a display name or resource reference must be provided",
            "expression": "(reference.exists() or (identifier.exists() and display.exists()))",
            "source": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-CommunicationRequest"
          },
          {
            "key": "patient-nhs",
            "severity": "error",
            "human": "Supplied NHS Number is outside the English and Welsh NHS Number range or length of the number is wrong.",
            "expression": "identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists().not() or (identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists()  and identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').value.matches('^([456789]{1}[0-9]{9})$'))",
            "source": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-CommunicationRequest"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
          },
          {
            "identity": "workflow",
            "map": "Request.subject"
          },
          {
            "identity": "w5",
            "map": "FiveWs.subject[x]"
          }
        ]
      },
      {
        "id": "CommunicationRequest.subject.id",
        "path": "CommunicationRequest.subject.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "Unique id for inter-element referencing",
        "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "string"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "condition": [
          "ele-1"
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "CommunicationRequest.subject.extension",
        "path": "CommunicationRequest.subject.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "description": "Extensions are always sliced by (at least) url",
          "rules": "open"
        },
        "short": "Additional content defined by implementations",
        "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 managable, 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.",
        "comment": "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.subject.reference",
        "path": "CommunicationRequest.subject.reference",
        "short": "Literal reference, Relative, internal or absolute URL",
        "definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
        "comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Reference.reference",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "string"
          }
        ],
        "condition": [
          "ref-2",
          "ref-1"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.subject.type",
        "path": "CommunicationRequest.subject.type",
        "short": "Type the reference refers to (e.g. \"Patient\") - must be a resource in resources",
        "definition": "The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. \"Patient\" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).",
        "comment": "This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Reference.type",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "uri"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/binding-definition",
              "valueString": "Aa resource (or, for logical models, the URI of the logical model)."
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "FHIRResourceTypeExt"
            }
          ],
          "strength": "extensible",
          "description": "Aa resource (or, for logical models, the URI of the logical model).",
          "valueSet": "http://hl7.org/fhir/ValueSet/resource-types"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.subject.identifier",
        "path": "CommunicationRequest.subject.identifier",
        "short": "Logical reference, when literal reference is not known",
        "definition": "An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
        "comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference.  For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport).  One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).\n\nThis element only allows for a single identifier. In the case where additional identifers are required, use the [http://hl7.org/fhir/StructureDefinition/additionalIdentifier](http://hl7.org/fhir/extensions/StructureDefinition-additionalIdentifier.html) extension.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Reference.identifier",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Identifier"
          }
        ],
        "condition": [
          "ref-2"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ident-1",
            "severity": "warning",
            "human": "Identifier with no value has limited utility.  If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason",
            "expression": "value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Identifier"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
          },
          {
            "identity": "rim",
            "map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]"
          },
          {
            "identity": "servd",
            "map": "Identifier"
          },
          {
            "identity": "rim",
            "map": ".identifier"
          }
        ]
      },
      {
        "id": "CommunicationRequest.subject.identifier.id",
        "path": "CommunicationRequest.subject.identifier.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "Unique id for inter-element referencing",
        "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "string"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "condition": [
          "ele-1"
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "CommunicationRequest.subject.identifier.extension",
        "path": "CommunicationRequest.subject.identifier.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "description": "Extensions are always sliced by (at least) url",
          "rules": "open"
        },
        "short": "Additional content defined by implementations",
        "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 managable, 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.",
        "comment": "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.subject.identifier.use",
        "path": "CommunicationRequest.subject.identifier.use",
        "short": "usual | official | temp | secondary | old (If known)",
        "definition": "The purpose of this identifier.",
        "comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
        "requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Identifier.use",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": true,
        "isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/binding-definition",
              "valueString": "Identifies the purpose for this identifier, if known ."
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "IdentifierUse"
            }
          ],
          "strength": "required",
          "description": "Identifies the purpose for this identifier, if known .",
          "valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|5.0.0"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "N/A"
          },
          {
            "identity": "rim",
            "map": "Role.code or implied by context"
          }
        ]
      },
      {
        "id": "CommunicationRequest.subject.identifier.type",
        "path": "CommunicationRequest.subject.identifier.type",
        "short": "Description of identifier",
        "definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
        "comment": "This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.   Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
        "requirements": "Allows users to make use of identifiers when the identifier system is not known.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Identifier.type",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/binding-definition",
              "valueString": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose."
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "IdentifierType"
            }
          ],
          "strength": "extensible",
          "description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
          "valueSet": "http://hl7.org/fhir/ValueSet/identifier-type"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "CE/CNE/CWE"
          },
          {
            "identity": "rim",
            "map": "CD"
          },
          {
            "identity": "orim",
            "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
          },
          {
            "identity": "v2",
            "map": "CX.5"
          },
          {
            "identity": "rim",
            "map": "Role.code or implied by context"
          }
        ]
      },
      {
        "id": "CommunicationRequest.subject.identifier.system",
        "path": "CommunicationRequest.subject.identifier.system",
        "short": "The namespace for the identifier value",
        "definition": "Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.",
        "comment": "Identifier.system is always case sensitive.",
        "requirements": "There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Identifier.system",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "uri"
          }
        ],
        "example": [
          {
            "label": "General",
            "valueUri": "http://www.acme.com/identifiers/patient"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "CX.4 / EI-2-4"
          },
          {
            "identity": "rim",
            "map": "II.root or Role.id.root"
          },
          {
            "identity": "servd",
            "map": "./IdentifierType"
          }
        ]
      },
      {
        "id": "CommunicationRequest.subject.identifier.value",
        "path": "CommunicationRequest.subject.identifier.value",
        "short": "The value that is unique",
        "definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
        "comment": "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [http://hl7.org/fhir/StructureDefinition/rendered-value](http://hl7.org/fhir/extensions/StructureDefinition-rendered-value.html)). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Identifier.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "string"
          }
        ],
        "example": [
          {
            "label": "General",
            "valueString": "123456"
          }
        ],
        "condition": [
          "ident-1"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "CX.1 / EI.1"
          },
          {
            "identity": "rim",
            "map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
          },
          {
            "identity": "servd",
            "map": "./Value"
          }
        ]
      },
      {
        "id": "CommunicationRequest.subject.identifier.period",
        "path": "CommunicationRequest.subject.identifier.period",
        "short": "Time period when id is/was valid for use",
        "definition": "Time period during which identifier is/was valid for use.",
        "comment": "A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration).",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Identifier.period",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Period"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "per-1",
            "severity": "error",
            "human": "If present, start SHALL have a lower or equal value than end",
            "expression": "start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() <= end.highBoundary())",
            "source": "http://hl7.org/fhir/StructureDefinition/Period"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "DR"
          },
          {
            "identity": "rim",
            "map": "IVL<TS>[lowClosed=\"true\" and highClosed=\"true\"] or URG<TS>[lowClosed=\"true\" and highClosed=\"true\"]"
          },
          {
            "identity": "v2",
            "map": "CX.7 + CX.8"
          },
          {
            "identity": "rim",
            "map": "Role.effectiveTime or implied by context"
          },
          {
            "identity": "servd",
            "map": "./StartDate and ./EndDate"
          }
        ]
      },
      {
        "id": "CommunicationRequest.subject.identifier.assigner",
        "path": "CommunicationRequest.subject.identifier.assigner",
        "short": "Organization that issued id (may be just text)",
        "definition": "Organization that issued/manages the identifier.",
        "comment": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Identifier.assigner",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Organization"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ref-1",
            "severity": "error",
            "human": "SHALL have a contained resource if a local reference is provided",
            "expression": "reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          },
          {
            "key": "ref-2",
            "severity": "error",
            "human": "At least one of reference, identifier and display SHALL be present (unless an extension is provided).",
            "expression": "reference.exists() or identifier.exists() or display.exists() or extension.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
          },
          {
            "identity": "v2",
            "map": "CX.4 / (CX.4,CX.9,CX.10)"
          },
          {
            "identity": "rim",
            "map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"
          },
          {
            "identity": "servd",
            "map": "./IdentifierIssuingAuthority"
          }
        ]
      },
      {
        "id": "CommunicationRequest.subject.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          },
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "CommunicationRequest.subject.display",
        "short": "Text alternative for the resource",
        "definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
        "comment": "This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Reference.display",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "string"
          }
        ],
        "condition": [
          "ref-2"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.about",
        "path": "CommunicationRequest.about",
        "short": "Resources that pertain to this communication request",
        "definition": "Other resources that pertain to this communication request and to which this communication request should be associated.",
        "comment": "Don't use CommunicationRequest.about element when a more specific element exists, such as basedOn, reasonReference, or replaces.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "CommunicationRequest.about",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Resource"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ref-1",
            "severity": "error",
            "human": "SHALL have a contained resource if a local reference is provided",
            "expression": "reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          },
          {
            "key": "ref-2",
            "severity": "error",
            "human": "At least one of reference, identifier and display SHALL be present (unless an extension is provided).",
            "expression": "reference.exists() or identifier.exists() or display.exists() or extension.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
          },
          {
            "identity": "workflow",
            "map": "Request.supportingInfo"
          },
          {
            "identity": "w5",
            "map": "FiveWs.context"
          }
        ]
      },
      {
        "id": "CommunicationRequest.encounter",
        "path": "CommunicationRequest.encounter",
        "short": "The Encounter during which this CommunicationRequest was created",
        "definition": "The Encounter during which this CommunicationRequest was created or to which the creation of this record is tightly associated.",
        "comment": "This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "CommunicationRequest.encounter",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Encounter"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ref-1",
            "severity": "error",
            "human": "SHALL have a contained resource if a local reference is provided",
            "expression": "reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          },
          {
            "key": "ref-2",
            "severity": "error",
            "human": "At least one of reference, identifier and display SHALL be present (unless an extension is provided).",
            "expression": "reference.exists() or identifier.exists() or display.exists() or extension.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
          },
          {
            "identity": "workflow",
            "map": "Request.encounter"
          },
          {
            "identity": "w5",
            "map": "FiveWs.context"
          }
        ]
      },
      {
        "id": "CommunicationRequest.payload",
        "path": "CommunicationRequest.payload",
        "short": "Message payload",
        "definition": "#### NHSApp\r\n\r\n**In App Messages** \r\n\r\nNHSApp supports a subset of Markdown for in-app messages, please see API documentation for more details. Only `contentString` is supported.\r\n\r\n```json\r\n  \r\n    \"payload\":  [\r\n        {\r\n            \"contentString\": \"You have a new appointment, please confirm you can attend. Open the Onboarded Third Party appointment [here](https://www.nhsapp.service.nhs.uk/appointments/hospital-appointments)\"\r\n        }\r\n    ]\r\n```\r\n\r\n**Push Notifications**\r\n\r\nOnly `contentReference` is supported and this should contain the URL to a page within the NHS App to be opened when the notification is tapped. If this property is not specified, the App will open on the home screen.\r\n\r\n```json\r\n  \r\n    \"payload\":  [\r\n        {\r\n            \"contentReference\": {\r\n                \"reference\": \"https://www.nhsapp.service.nhs.uk/patient/messages/app-messaging\",\r\n                \"display\": \"You have a new message. The message may contain something important.\"\r\n            }\r\n        }\r\n    ],\r\n```\r\n\r\n#### EPS\r\n\r\n**CommunicationRequest** is used in Electronic Prescription Service (EPS) to convey patient specific information. This includes:\r\n\r\n* patient information - messages to the patient\r\n* medications - list of authorised repeat medications which is contained on a FHIR List resource, details and example list of repeat medications can be found in profile `UKCore-List`\r\n\r\nThese would be traditionally printed on the right hand side of the FP10 stationery.\r\n\r\n**CommunicationRequest should not contain Clinical information regarding the prescriptions, these should be conveyed in the MedicationRequest resource.**\r\n\r\n```json\r\n\r\n    \"payload\":  [\r\n        {\r\n            \"contentString\": \"Please make an appointment to see your GP. Review date due\"\r\n        },\r\n        {\r\n            \"contentReference\": {\r\n                \"reference\": \"urn:uuid:d0f003a0-8763-43d5-a264-ce52a38901c9\",\r\n                \"display\": \"List of Repeat Medications for re-ordering\"\r\n            }\r\n        }\r\n    ],\r\n```",
        "comment": "The payload will consist of message to the Patient and/or a reference to a list of active repeat medications.",
        "min": 1,
        "max": "*",
        "base": {
          "path": "CommunicationRequest.payload",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "CommunicationRequest.payload.id",
        "path": "CommunicationRequest.payload.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "Unique id for inter-element referencing",
        "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "string"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "condition": [
          "ele-1"
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "CommunicationRequest.payload.extension",
        "path": "CommunicationRequest.payload.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "description": "Extensions are always sliced by (at least) url",
          "rules": "open"
        },
        "short": "Additional content defined by implementations",
        "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 managable, 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.",
        "comment": "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.payload.extension:deviceContent",
        "path": "CommunicationRequest.payload.extension",
        "sliceName": "deviceContent",
        "short": "Optional Extensions Element",
        "definition": "Optional Extension Element - found in all resources.",
        "comment": "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension",
            "profile": [
              "https://fhir.nhs.uk/StructureDefinition/Extension-Spine-CommunicationPayload"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.payload.modifierExtension",
        "path": "CommunicationRequest.payload.modifierExtension",
        "short": "Extensions that cannot be ignored even if unrecognized",
        "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 managable, 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
        "comment": "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.",
        "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](extensibility.html#modifierExtension).",
        "alias": [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "BackboneElement.modifierExtension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier": true,
        "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.payload.content[x]",
        "path": "CommunicationRequest.payload.content[x]",
        "short": "Message part content",
        "definition": "The communicated content (or for multi-part communications, one portion of the communication).",
        "comment": "The content can be codified or textual.  As an example of codified content, when working with machine generated communications, the payload may be drawn from a finite, terminology defined set of communications, especially for short, status update kinds of communications where more of a natural language approach isn't appropriate.\n\nIf the content isn't codified, contentCodeableConcept.text can be used.  \n\nWhen using contentCodeableConcept, the CodeableConcept is what is being communicated and is not a categorization of the content.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "CommunicationRequest.payload.content[x]",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "Attachment"
          },
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Resource"
            ]
          },
          {
            "code": "CodeableConcept"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "workflow",
            "map": "Request.note"
          }
        ]
      },
      {
        "id": "CommunicationRequest.occurrence[x]",
        "path": "CommunicationRequest.occurrence[x]",
        "short": "When scheduled",
        "definition": "The time when this communication is to occur.",
        "alias": [
          "timing"
        ],
        "min": 0,
        "max": "1",
        "base": {
          "path": "CommunicationRequest.occurrence[x]",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "dateTime"
          },
          {
            "code": "Period"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "workflow",
            "map": "Request.occurrence[x]"
          },
          {
            "identity": "w5",
            "map": "FiveWs.planned"
          }
        ]
      },
      {
        "id": "CommunicationRequest.authoredOn",
        "path": "CommunicationRequest.authoredOn",
        "short": "When request transitioned to being actionable",
        "definition": "For draft requests, indicates the date of initial creation.  For requests with other statuses, indicates the date of activation.",
        "comment": "UTC offset is allowed for dates and partial dates",
        "alias": [
          "createdOn"
        ],
        "min": 0,
        "max": "1",
        "base": {
          "path": "CommunicationRequest.authoredOn",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "workflow",
            "map": "Request.authoredOn"
          },
          {
            "identity": "w5",
            "map": "FiveWs.recorded"
          }
        ]
      },
      {
        "id": "CommunicationRequest.requester",
        "path": "CommunicationRequest.requester",
        "short": "Who asks for the information to be shared",
        "definition": "The person/organisation making the communication request. This **SHOULD** use reference identifiers.\r\n\r\n```json\r\n\r\n    \"requester\": {\r\n        \"type\": \"Organization\",\r\n        \"identifier\": {\r\n            \"system\": \"https://fhir.nhs.uk/Id/ods-organization-code\",\r\n            \"value\": \"RBA\"\r\n        },\r\n        \"display\": \"TAUNTON AND SOMERSET NHS FOUNDATION TRUST\"\r\n    },\r\n```",
        "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.",
        "alias": [
          "author"
        ],
        "min": 1,
        "max": "1",
        "base": {
          "path": "CommunicationRequest.requester",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient",
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole",
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Organization"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ref-1",
            "severity": "error",
            "human": "SHALL have a contained resource if a local reference is provided",
            "expression": "reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          },
          {
            "key": "ref-2",
            "severity": "error",
            "human": "At least one of reference, identifier and display SHALL be present (unless an extension is provided).",
            "expression": "reference.exists() or identifier.exists() or display.exists() or extension.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
          },
          {
            "identity": "workflow",
            "map": "Request.requester"
          },
          {
            "identity": "w5",
            "map": "FiveWs.author"
          },
          {
            "identity": "rim",
            "map": ".participation[typeCode=AUT].role"
          }
        ]
      },
      {
        "id": "CommunicationRequest.requester.id",
        "path": "CommunicationRequest.requester.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "Unique id for inter-element referencing",
        "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "string"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "condition": [
          "ele-1"
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "CommunicationRequest.requester.extension",
        "path": "CommunicationRequest.requester.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "description": "Extensions are always sliced by (at least) url",
          "rules": "open"
        },
        "short": "Additional content defined by implementations",
        "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 managable, 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.",
        "comment": "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.requester.reference",
        "path": "CommunicationRequest.requester.reference",
        "short": "Literal reference, Relative, internal or absolute URL",
        "definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
        "comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Reference.reference",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "string"
          }
        ],
        "condition": [
          "ref-2",
          "ref-1"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.requester.type",
        "path": "CommunicationRequest.requester.type",
        "short": "Type the reference refers to (e.g. \"Patient\") - must be a resource in resources",
        "definition": "The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. \"Patient\" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).",
        "comment": "This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Reference.type",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "uri"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/binding-definition",
              "valueString": "Aa resource (or, for logical models, the URI of the logical model)."
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "FHIRResourceTypeExt"
            }
          ],
          "strength": "extensible",
          "description": "Aa resource (or, for logical models, the URI of the logical model).",
          "valueSet": "http://hl7.org/fhir/ValueSet/resource-types"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.requester.identifier",
        "path": "CommunicationRequest.requester.identifier",
        "short": "Logical reference, when literal reference is not known",
        "definition": "An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
        "comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference.  For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport).  One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).\n\nThis element only allows for a single identifier. In the case where additional identifers are required, use the [http://hl7.org/fhir/StructureDefinition/additionalIdentifier](http://hl7.org/fhir/extensions/StructureDefinition-additionalIdentifier.html) extension.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Reference.identifier",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Identifier"
          }
        ],
        "condition": [
          "ref-2"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ident-1",
            "severity": "warning",
            "human": "Identifier with no value has limited utility.  If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason",
            "expression": "value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Identifier"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
          },
          {
            "identity": "rim",
            "map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]"
          },
          {
            "identity": "servd",
            "map": "Identifier"
          },
          {
            "identity": "rim",
            "map": ".identifier"
          }
        ]
      },
      {
        "id": "CommunicationRequest.requester.identifier.id",
        "path": "CommunicationRequest.requester.identifier.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "Unique id for inter-element referencing",
        "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "string"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "condition": [
          "ele-1"
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "CommunicationRequest.requester.identifier.extension",
        "path": "CommunicationRequest.requester.identifier.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "description": "Extensions are always sliced by (at least) url",
          "rules": "open"
        },
        "short": "Additional content defined by implementations",
        "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 managable, 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.",
        "comment": "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.requester.identifier.use",
        "path": "CommunicationRequest.requester.identifier.use",
        "short": "usual | official | temp | secondary | old (If known)",
        "definition": "The purpose of this identifier.",
        "comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
        "requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Identifier.use",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": true,
        "isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/binding-definition",
              "valueString": "Identifies the purpose for this identifier, if known ."
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "IdentifierUse"
            }
          ],
          "strength": "required",
          "description": "Identifies the purpose for this identifier, if known .",
          "valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|5.0.0"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "N/A"
          },
          {
            "identity": "rim",
            "map": "Role.code or implied by context"
          }
        ]
      },
      {
        "id": "CommunicationRequest.requester.identifier.type",
        "path": "CommunicationRequest.requester.identifier.type",
        "short": "Description of identifier",
        "definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
        "comment": "This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.   Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
        "requirements": "Allows users to make use of identifiers when the identifier system is not known.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Identifier.type",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/binding-definition",
              "valueString": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose."
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "IdentifierType"
            }
          ],
          "strength": "extensible",
          "description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
          "valueSet": "http://hl7.org/fhir/ValueSet/identifier-type"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "CE/CNE/CWE"
          },
          {
            "identity": "rim",
            "map": "CD"
          },
          {
            "identity": "orim",
            "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
          },
          {
            "identity": "v2",
            "map": "CX.5"
          },
          {
            "identity": "rim",
            "map": "Role.code or implied by context"
          }
        ]
      },
      {
        "id": "CommunicationRequest.requester.identifier.system",
        "path": "CommunicationRequest.requester.identifier.system",
        "short": "The namespace for the identifier value",
        "definition": "Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.",
        "comment": "Identifier.system is always case sensitive.",
        "requirements": "There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Identifier.system",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "uri"
          }
        ],
        "example": [
          {
            "label": "General",
            "valueUri": "http://www.acme.com/identifiers/patient"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "CX.4 / EI-2-4"
          },
          {
            "identity": "rim",
            "map": "II.root or Role.id.root"
          },
          {
            "identity": "servd",
            "map": "./IdentifierType"
          }
        ]
      },
      {
        "id": "CommunicationRequest.requester.identifier.value",
        "path": "CommunicationRequest.requester.identifier.value",
        "short": "The value that is unique",
        "definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
        "comment": "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [http://hl7.org/fhir/StructureDefinition/rendered-value](http://hl7.org/fhir/extensions/StructureDefinition-rendered-value.html)). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Identifier.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "string"
          }
        ],
        "example": [
          {
            "label": "General",
            "valueString": "123456"
          }
        ],
        "condition": [
          "ident-1"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "CX.1 / EI.1"
          },
          {
            "identity": "rim",
            "map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
          },
          {
            "identity": "servd",
            "map": "./Value"
          }
        ]
      },
      {
        "id": "CommunicationRequest.requester.identifier.period",
        "path": "CommunicationRequest.requester.identifier.period",
        "short": "Time period when id is/was valid for use",
        "definition": "Time period during which identifier is/was valid for use.",
        "comment": "A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration).",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Identifier.period",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Period"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "per-1",
            "severity": "error",
            "human": "If present, start SHALL have a lower or equal value than end",
            "expression": "start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() <= end.highBoundary())",
            "source": "http://hl7.org/fhir/StructureDefinition/Period"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "DR"
          },
          {
            "identity": "rim",
            "map": "IVL<TS>[lowClosed=\"true\" and highClosed=\"true\"] or URG<TS>[lowClosed=\"true\" and highClosed=\"true\"]"
          },
          {
            "identity": "v2",
            "map": "CX.7 + CX.8"
          },
          {
            "identity": "rim",
            "map": "Role.effectiveTime or implied by context"
          },
          {
            "identity": "servd",
            "map": "./StartDate and ./EndDate"
          }
        ]
      },
      {
        "id": "CommunicationRequest.requester.identifier.assigner",
        "path": "CommunicationRequest.requester.identifier.assigner",
        "short": "Organization that issued id (may be just text)",
        "definition": "Organization that issued/manages the identifier.",
        "comment": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Identifier.assigner",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Organization"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ref-1",
            "severity": "error",
            "human": "SHALL have a contained resource if a local reference is provided",
            "expression": "reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          },
          {
            "key": "ref-2",
            "severity": "error",
            "human": "At least one of reference, identifier and display SHALL be present (unless an extension is provided).",
            "expression": "reference.exists() or identifier.exists() or display.exists() or extension.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
          },
          {
            "identity": "v2",
            "map": "CX.4 / (CX.4,CX.9,CX.10)"
          },
          {
            "identity": "rim",
            "map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"
          },
          {
            "identity": "servd",
            "map": "./IdentifierIssuingAuthority"
          }
        ]
      },
      {
        "id": "CommunicationRequest.requester.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          },
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "CommunicationRequest.requester.display",
        "short": "Text alternative for the resource",
        "definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
        "comment": "This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Reference.display",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "string"
          }
        ],
        "condition": [
          "ref-2"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.recipient",
        "path": "CommunicationRequest.recipient",
        "short": "Who to share the information with",
        "definition": "The persons/organisations who will receive the communication request. This **SHOULD** use reference identifiers.\r\n\r\n```json\r\n\r\n    \"recipient\":  [\r\n        {\r\n            \"type\": \"Patient\",\r\n            \"identifier\": {\r\n                \"system\": \"https://fhir.nhs.uk/Id/nhs-number\",\r\n                \"value\": \"9453740519\"\r\n            }\r\n        }\r\n    ]\r\n```",
        "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.",
        "min": 1,
        "max": "*",
        "base": {
          "path": "CommunicationRequest.recipient",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Group",
              "http://hl7.org/fhir/StructureDefinition/CareTeam",
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Organization",
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient",
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Practitioner",
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole",
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-HealthcareService"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ref-1",
            "severity": "error",
            "human": "SHALL have a contained resource if a local reference is provided",
            "expression": "reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          },
          {
            "key": "ref-2",
            "severity": "error",
            "human": "At least one of reference, identifier and display SHALL be present (unless an extension is provided).",
            "expression": "reference.exists() or identifier.exists() or display.exists() or extension.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
          },
          {
            "identity": "workflow",
            "map": "Request.performer"
          },
          {
            "identity": "w5",
            "map": "FiveWs.actor"
          }
        ]
      },
      {
        "id": "CommunicationRequest.recipient.id",
        "path": "CommunicationRequest.recipient.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "Unique id for inter-element referencing",
        "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "string"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "condition": [
          "ele-1"
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "CommunicationRequest.recipient.extension",
        "path": "CommunicationRequest.recipient.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "description": "Extensions are always sliced by (at least) url",
          "rules": "open"
        },
        "short": "Additional content defined by implementations",
        "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 managable, 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.",
        "comment": "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.recipient.reference",
        "path": "CommunicationRequest.recipient.reference",
        "short": "Literal reference, Relative, internal or absolute URL",
        "definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
        "comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Reference.reference",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "string"
          }
        ],
        "condition": [
          "ref-2",
          "ref-1"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.recipient.type",
        "path": "CommunicationRequest.recipient.type",
        "short": "Type the reference refers to (e.g. \"Patient\") - must be a resource in resources",
        "definition": "The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. \"Patient\" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).",
        "comment": "This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Reference.type",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "uri"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/binding-definition",
              "valueString": "Aa resource (or, for logical models, the URI of the logical model)."
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "FHIRResourceTypeExt"
            }
          ],
          "strength": "extensible",
          "description": "Aa resource (or, for logical models, the URI of the logical model).",
          "valueSet": "http://hl7.org/fhir/ValueSet/resource-types"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.recipient.identifier",
        "path": "CommunicationRequest.recipient.identifier",
        "short": "Logical reference, when literal reference is not known",
        "definition": "An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
        "comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference.  For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport).  One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).\n\nThis element only allows for a single identifier. In the case where additional identifers are required, use the [http://hl7.org/fhir/StructureDefinition/additionalIdentifier](http://hl7.org/fhir/extensions/StructureDefinition-additionalIdentifier.html) extension.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Reference.identifier",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Identifier"
          }
        ],
        "condition": [
          "ref-2"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ident-1",
            "severity": "warning",
            "human": "Identifier with no value has limited utility.  If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason",
            "expression": "value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Identifier"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
          },
          {
            "identity": "rim",
            "map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]"
          },
          {
            "identity": "servd",
            "map": "Identifier"
          },
          {
            "identity": "rim",
            "map": ".identifier"
          }
        ]
      },
      {
        "id": "CommunicationRequest.recipient.identifier.id",
        "path": "CommunicationRequest.recipient.identifier.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "Unique id for inter-element referencing",
        "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "string"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "condition": [
          "ele-1"
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "CommunicationRequest.recipient.identifier.extension",
        "path": "CommunicationRequest.recipient.identifier.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "description": "Extensions are always sliced by (at least) url",
          "rules": "open"
        },
        "short": "Additional content defined by implementations",
        "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 managable, 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.",
        "comment": "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.recipient.identifier.use",
        "path": "CommunicationRequest.recipient.identifier.use",
        "short": "usual | official | temp | secondary | old (If known)",
        "definition": "The purpose of this identifier.",
        "comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
        "requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Identifier.use",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "code"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": true,
        "isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/binding-definition",
              "valueString": "Identifies the purpose for this identifier, if known ."
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "IdentifierUse"
            }
          ],
          "strength": "required",
          "description": "Identifies the purpose for this identifier, if known .",
          "valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|5.0.0"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "N/A"
          },
          {
            "identity": "rim",
            "map": "Role.code or implied by context"
          }
        ]
      },
      {
        "id": "CommunicationRequest.recipient.identifier.type",
        "path": "CommunicationRequest.recipient.identifier.type",
        "short": "Description of identifier",
        "definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
        "comment": "This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.   Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
        "requirements": "Allows users to make use of identifiers when the identifier system is not known.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Identifier.type",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/binding-definition",
              "valueString": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose."
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "IdentifierType"
            }
          ],
          "strength": "extensible",
          "description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
          "valueSet": "http://hl7.org/fhir/ValueSet/identifier-type"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "CE/CNE/CWE"
          },
          {
            "identity": "rim",
            "map": "CD"
          },
          {
            "identity": "orim",
            "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
          },
          {
            "identity": "v2",
            "map": "CX.5"
          },
          {
            "identity": "rim",
            "map": "Role.code or implied by context"
          }
        ]
      },
      {
        "id": "CommunicationRequest.recipient.identifier.system",
        "path": "CommunicationRequest.recipient.identifier.system",
        "short": "The namespace for the identifier value",
        "definition": "Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.",
        "comment": "Identifier.system is always case sensitive.",
        "requirements": "There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Identifier.system",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "uri"
          }
        ],
        "example": [
          {
            "label": "General",
            "valueUri": "http://www.acme.com/identifiers/patient"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "CX.4 / EI-2-4"
          },
          {
            "identity": "rim",
            "map": "II.root or Role.id.root"
          },
          {
            "identity": "servd",
            "map": "./IdentifierType"
          }
        ]
      },
      {
        "id": "CommunicationRequest.recipient.identifier.value",
        "path": "CommunicationRequest.recipient.identifier.value",
        "short": "The value that is unique",
        "definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
        "comment": "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [http://hl7.org/fhir/StructureDefinition/rendered-value](http://hl7.org/fhir/extensions/StructureDefinition-rendered-value.html)). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Identifier.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "string"
          }
        ],
        "example": [
          {
            "label": "General",
            "valueString": "123456"
          }
        ],
        "condition": [
          "ident-1"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "CX.1 / EI.1"
          },
          {
            "identity": "rim",
            "map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
          },
          {
            "identity": "servd",
            "map": "./Value"
          }
        ]
      },
      {
        "id": "CommunicationRequest.recipient.identifier.period",
        "path": "CommunicationRequest.recipient.identifier.period",
        "short": "Time period when id is/was valid for use",
        "definition": "Time period during which identifier is/was valid for use.",
        "comment": "A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration).",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Identifier.period",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Period"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "per-1",
            "severity": "error",
            "human": "If present, start SHALL have a lower or equal value than end",
            "expression": "start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() <= end.highBoundary())",
            "source": "http://hl7.org/fhir/StructureDefinition/Period"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "DR"
          },
          {
            "identity": "rim",
            "map": "IVL<TS>[lowClosed=\"true\" and highClosed=\"true\"] or URG<TS>[lowClosed=\"true\" and highClosed=\"true\"]"
          },
          {
            "identity": "v2",
            "map": "CX.7 + CX.8"
          },
          {
            "identity": "rim",
            "map": "Role.effectiveTime or implied by context"
          },
          {
            "identity": "servd",
            "map": "./StartDate and ./EndDate"
          }
        ]
      },
      {
        "id": "CommunicationRequest.recipient.identifier.assigner",
        "path": "CommunicationRequest.recipient.identifier.assigner",
        "short": "Organization that issued id (may be just text)",
        "definition": "Organization that issued/manages the identifier.",
        "comment": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Identifier.assigner",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Organization"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ref-1",
            "severity": "error",
            "human": "SHALL have a contained resource if a local reference is provided",
            "expression": "reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          },
          {
            "key": "ref-2",
            "severity": "error",
            "human": "At least one of reference, identifier and display SHALL be present (unless an extension is provided).",
            "expression": "reference.exists() or identifier.exists() or display.exists() or extension.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
          },
          {
            "identity": "v2",
            "map": "CX.4 / (CX.4,CX.9,CX.10)"
          },
          {
            "identity": "rim",
            "map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"
          },
          {
            "identity": "servd",
            "map": "./IdentifierIssuingAuthority"
          }
        ]
      },
      {
        "id": "CommunicationRequest.recipient.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          },
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "CommunicationRequest.recipient.display",
        "short": "Text alternative for the resource",
        "definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
        "comment": "This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Reference.display",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "string"
          }
        ],
        "condition": [
          "ref-2"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "CommunicationRequest.informationProvider",
        "path": "CommunicationRequest.informationProvider",
        "short": "Who should share the information",
        "definition": "The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication.",
        "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "CommunicationRequest.informationProvider",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Device",
              "http://hl7.org/fhir/StructureDefinition/Organization",
              "http://hl7.org/fhir/StructureDefinition/Patient",
              "http://hl7.org/fhir/StructureDefinition/Practitioner",
              "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
              "http://hl7.org/fhir/StructureDefinition/RelatedPerson",
              "http://hl7.org/fhir/StructureDefinition/HealthcareService",
              "http://hl7.org/fhir/StructureDefinition/Endpoint"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ref-1",
            "severity": "error",
            "human": "SHALL have a contained resource if a local reference is provided",
            "expression": "reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          },
          {
            "key": "ref-2",
            "severity": "error",
            "human": "At least one of reference, identifier and display SHALL be present (unless an extension is provided).",
            "expression": "reference.exists() or identifier.exists() or display.exists() or extension.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Reference"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
          },
          {
            "identity": "workflow",
            "map": "Request.performer"
          },
          {
            "identity": "w5",
            "map": "FiveWs.actor"
          }
        ]
      },
      {
        "id": "CommunicationRequest.reason",
        "path": "CommunicationRequest.reason",
        "short": "Why is communication needed?",
        "definition": "Describes why the request is being made in coded or textual form.",
        "comment": "Textual reasons can be captured using reasonCode.text.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "CommunicationRequest.reason",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "CodeableReference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Resource"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "CommunicationReason"
            }
          ],
          "strength": "example",
          "description": "Codes for describing reasons for the occurrence of a communication.",
          "valueSet": "http://terminology.hl7.org/ValueSet/v3-ActReason"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "workflow",
            "map": "Request.reason"
          },
          {
            "identity": "w5",
            "map": "FiveWs.why[x]"
          },
          {
            "identity": "rim",
            "map": ".reasonCode"
          }
        ]
      },
      {
        "id": "CommunicationRequest.note",
        "path": "CommunicationRequest.note",
        "short": "Comments made about communication request",
        "definition": "Comments made about the request by the requester, sender, recipient, subject or other participants.",
        "comment": "For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time.  This element may need to be included in narrative because of the potential for modifying information.  *Annotations SHOULD NOT* be used to communicate \"modifying\" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).",
        "min": 0,
        "max": "*",
        "base": {
          "path": "CommunicationRequest.note",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Annotation"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "v2",
            "map": "N/A"
          },
          {
            "identity": "rim",
            "map": "Act"
          },
          {
            "identity": "workflow",
            "map": "Request.note"
          },
          {
            "identity": "rim",
            "map": ".inboundRelationship(typeCode=SUBJ].source[classCode=ANNGEN, moodCode=EVN].value[xsi:type=ST]"
          }
        ]
      },
      {
        "id": "CommunicationRequest.sender",
        "path": "CommunicationRequest.sender",
        "base": {
          "path": "CommunicationRequest.sender"
        }
      },
      {
        "id": "CommunicationRequest.reasonCode",
        "path": "CommunicationRequest.reasonCode",
        "base": {
          "path": "CommunicationRequest.reasonCode"
        }
      }
    ]
  },
  "differential": {
    "element": [
      {
        "id": "CommunicationRequest.status",
        "path": "CommunicationRequest.status",
        "mustSupport": true
      },
      {
        "id": "CommunicationRequest.medium",
        "path": "CommunicationRequest.medium",
        "binding": {
          "strength": "extensible",
          "valueSet": "https://fhir.nhs.uk/ValueSet/Spine-CommunicationChannel-vs"
        }
      },
      {
        "id": "CommunicationRequest.subject",
        "path": "CommunicationRequest.subject",
        "definition": "The patient or group that is the focus of this communication request.\r\n\r\n```json\r\n\"subject\": {\r\n        \"type\": \"Patient\",\r\n        \"identifier\": {\r\n            \"system\": \"https://fhir.nhs.uk/Id/nhs-number\",\r\n            \"value\": \"9453740519\"\r\n        }\r\n    }\r\n```",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient"
            ]
          }
        ],
        "constraint": [
          {
            "key": "patient-reference",
            "severity": "warning",
            "human": "subject - An identifier reference plus a display name or resource reference must be provided",
            "expression": "(reference.exists() or (identifier.exists() and display.exists()))",
            "source": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-CommunicationRequest"
          },
          {
            "key": "patient-nhs",
            "severity": "error",
            "human": "Supplied NHS Number is outside the English and Welsh NHS Number range or length of the number is wrong.",
            "expression": "identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists().not() or (identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists()  and identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').value.matches('^([456789]{1}[0-9]{9})$'))",
            "source": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-CommunicationRequest"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "CommunicationRequest.subject.identifier.system",
        "path": "CommunicationRequest.subject.identifier.system",
        "min": 1
      },
      {
        "id": "CommunicationRequest.subject.identifier.value",
        "path": "CommunicationRequest.subject.identifier.value",
        "min": 1
      },
      {
        "id": "CommunicationRequest.payload",
        "path": "CommunicationRequest.payload",
        "definition": "#### NHSApp\r\n\r\n**In App Messages** \r\n\r\nNHSApp supports a subset of Markdown for in-app messages, please see API documentation for more details. Only `contentString` is supported.\r\n\r\n```json\r\n  \r\n    \"payload\":  [\r\n        {\r\n            \"contentString\": \"You have a new appointment, please confirm you can attend. Open the Onboarded Third Party appointment [here](https://www.nhsapp.service.nhs.uk/appointments/hospital-appointments)\"\r\n        }\r\n    ]\r\n```\r\n\r\n**Push Notifications**\r\n\r\nOnly `contentReference` is supported and this should contain the URL to a page within the NHS App to be opened when the notification is tapped. If this property is not specified, the App will open on the home screen.\r\n\r\n```json\r\n  \r\n    \"payload\":  [\r\n        {\r\n            \"contentReference\": {\r\n                \"reference\": \"https://www.nhsapp.service.nhs.uk/patient/messages/app-messaging\",\r\n                \"display\": \"You have a new message. The message may contain something important.\"\r\n            }\r\n        }\r\n    ],\r\n```\r\n\r\n#### EPS\r\n\r\n**CommunicationRequest** is used in Electronic Prescription Service (EPS) to convey patient specific information. This includes:\r\n\r\n* patient information - messages to the patient\r\n* medications - list of authorised repeat medications which is contained on a FHIR List resource, details and example list of repeat medications can be found in profile `UKCore-List`\r\n\r\nThese would be traditionally printed on the right hand side of the FP10 stationery.\r\n\r\n**CommunicationRequest should not contain Clinical information regarding the prescriptions, these should be conveyed in the MedicationRequest resource.**\r\n\r\n```json\r\n\r\n    \"payload\":  [\r\n        {\r\n            \"contentString\": \"Please make an appointment to see your GP. Review date due\"\r\n        },\r\n        {\r\n            \"contentReference\": {\r\n                \"reference\": \"urn:uuid:d0f003a0-8763-43d5-a264-ce52a38901c9\",\r\n                \"display\": \"List of Repeat Medications for re-ordering\"\r\n            }\r\n        }\r\n    ],\r\n```",
        "comment": "The payload will consist of message to the Patient and/or a reference to a list of active repeat medications.",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "CommunicationRequest.payload.extension",
        "path": "CommunicationRequest.payload.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 0
      },
      {
        "id": "CommunicationRequest.payload.extension:deviceContent",
        "path": "CommunicationRequest.payload.extension",
        "sliceName": "deviceContent",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "https://fhir.nhs.uk/StructureDefinition/Extension-Spine-CommunicationPayload"
            ]
          }
        ]
      },
      {
        "id": "CommunicationRequest.requester",
        "path": "CommunicationRequest.requester",
        "definition": "The person/organisation making the communication request. This **SHOULD** use reference identifiers.\r\n\r\n```json\r\n\r\n    \"requester\": {\r\n        \"type\": \"Organization\",\r\n        \"identifier\": {\r\n            \"system\": \"https://fhir.nhs.uk/Id/ods-organization-code\",\r\n            \"value\": \"RBA\"\r\n        },\r\n        \"display\": \"TAUNTON AND SOMERSET NHS FOUNDATION TRUST\"\r\n    },\r\n```",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient",
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole",
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Organization"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "CommunicationRequest.requester.identifier.system",
        "path": "CommunicationRequest.requester.identifier.system",
        "min": 1
      },
      {
        "id": "CommunicationRequest.requester.identifier.value",
        "path": "CommunicationRequest.requester.identifier.value",
        "min": 1
      },
      {
        "id": "CommunicationRequest.recipient",
        "path": "CommunicationRequest.recipient",
        "definition": "The persons/organisations who will receive the communication request. This **SHOULD** use reference identifiers.\r\n\r\n```json\r\n\r\n    \"recipient\":  [\r\n        {\r\n            \"type\": \"Patient\",\r\n            \"identifier\": {\r\n                \"system\": \"https://fhir.nhs.uk/Id/nhs-number\",\r\n                \"value\": \"9453740519\"\r\n            }\r\n        }\r\n    ]\r\n```",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Group",
              "http://hl7.org/fhir/StructureDefinition/CareTeam",
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Organization",
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient",
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Practitioner",
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole",
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-HealthcareService"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "CommunicationRequest.recipient.identifier.system",
        "path": "CommunicationRequest.recipient.identifier.system",
        "min": 1
      },
      {
        "id": "CommunicationRequest.recipient.identifier.value",
        "path": "CommunicationRequest.recipient.identifier.value",
        "min": 1
      },
      {
        "id": "CommunicationRequest.sender.identifier.system",
        "path": "CommunicationRequest.sender.identifier.system",
        "min": 1
      },
      {
        "id": "CommunicationRequest.sender.identifier.value",
        "path": "CommunicationRequest.sender.identifier.value",
        "min": 1
      },
      {
        "id": "CommunicationRequest.reasonCode",
        "path": "CommunicationRequest.reasonCode",
        "binding": {
          "strength": "preferred",
          "description": "UKCore event types",
          "valueSet": "https://fhir.nhs.uk/ValueSet/NHSDigital-message-events"
        }
      },
      {
        "id": "CommunicationRequest.reasonCode.coding.system",
        "path": "CommunicationRequest.reasonCode.coding.system",
        "min": 1
      },
      {
        "id": "CommunicationRequest.reasonCode.coding.code",
        "path": "CommunicationRequest.reasonCode.coding.code",
        "min": 1
      },
      {
        "id": "CommunicationRequest.reasonCode.coding.display",
        "path": "CommunicationRequest.reasonCode.coding.display",
        "min": 1
      }
    ]
  }
}