<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="97509562-0326-459e-a863-430574146520" />
  <url value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-CommunicationRequest" />
  <name value="NHSDigitalCommunicationRequest" />
  <status value="draft" />
  <fhirVersion value="4.0.1" />
  <mapping>
    <identity value="workflow" />
    <uri value="http://hl7.org/fhir/workflow" />
    <name value="Workflow Pattern" />
  </mapping>
  <mapping>
    <identity value="rim" />
    <uri value="http://hl7.org/v3" />
    <name value="RIM Mapping" />
  </mapping>
  <kind value="resource" />
  <abstract value="false" />
  <type value="CommunicationRequest" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/CommunicationRequest" />
  <derivation value="constraint" />
  <snapshot>
    <element id="CommunicationRequest">
      <path value="CommunicationRequest" />
      <short value="A request for information to be sent to a receiver" />
      <definition value="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 value="0" />
      <max value="*" />
      <base>
        <path value="CommunicationRequest" />
        <min value="0" />
        <max value="*" />
      </base>
      <constraint>
        <key value="dom-2" />
        <severity value="error" />
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
        <expression value="contained.contained.empty()" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="dom-4" />
        <severity value="error" />
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="dom-3" />
        <severity value="error" />
        <human value="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 value="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 value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown value="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." />
        </extension>
        <key value="dom-6" />
        <severity value="warning" />
        <human value="A resource should have narrative for robust management" />
        <expression value="text.`div`.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="dom-5" />
        <severity value="error" />
        <human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
        <expression value="contained.meta.security.empty()" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Entity. Role, or Act" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Entity, Role, or Act" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="workflow.order" />
      </mapping>
    </element>
    <element id="CommunicationRequest.id">
      <path value="CommunicationRequest.id" />
      <short value="Logical id of this artifact" />
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
      <comment value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Resource.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id" />
        </extension>
        <code value="id" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="CommunicationRequest.meta">
      <path value="CommunicationRequest.meta" />
      <short value="Metadata about the resource" />
      <definition value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Resource.meta" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Meta" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.implicitRules">
      <path value="CommunicationRequest.implicitRules" />
      <short value="A set of rules under which this content was created" />
      <definition value="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 value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Resource.implicitRules" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="true" />
      <isModifierReason value="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 value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="CommunicationRequest.language">
      <path value="CommunicationRequest.language" />
      <short value="Language of the resource content" />
      <definition value="The base language in which the resource is written." />
      <comment value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Resource.language" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language" />
        </extension>
        <strength value="required" />
        <description value="IETF language tag for a human language" />
        <valueSet value="http://hl7.org/fhir/ValueSet/all-languages|5.0.0" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="CommunicationRequest.text">
      <path value="CommunicationRequest.text" />
      <short value="Text summary of the resource, for human interpretation" />
      <definition value="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 &quot;clinically safe&quot; 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 value="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 &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later." />
      <alias value="narrative" />
      <alias value="html" />
      <alias value="xhtml" />
      <alias value="display" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="DomainResource.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Narrative" />
      </type>
      <condition value="dom-6" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Act.text?" />
      </mapping>
    </element>
    <element id="CommunicationRequest.contained">
      <path value="CommunicationRequest.contained" />
      <short value="Contained, inline Resources" />
      <definition value="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 value="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 value="inline resources" />
      <alias value="anonymous resources" />
      <alias value="contained resources" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.contained" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Resource" />
      </type>
      <condition value="dom-2" />
      <condition value="dom-4" />
      <condition value="dom-3" />
      <condition value="dom-5" />
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Entity. Role, or Act" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.extension">
      <path value="CommunicationRequest.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="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 value="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 value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.modifierExtension">
      <path value="CommunicationRequest.modifierExtension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Extensions that cannot be ignored" />
      <definition value="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.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
      <comment value="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 value="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 value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="true" />
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.identifier">
      <path value="CommunicationRequest.identifier" />
      <short value="Unique identifier" />
      <definition value="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 value="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 value="Allows identification of the communication request as it is known by various participating systems and in a way that remains consistent across servers." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="CommunicationRequest.identifier" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Identifier" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ident-1" />
        <severity value="warning" />
        <human value="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="value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Identifier" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="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]" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="Identifier" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.identifier" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.identifier" />
      </mapping>
    </element>
    <element id="CommunicationRequest.basedOn">
      <path value="CommunicationRequest.basedOn" />
      <short value="Fulfills plan or proposal" />
      <definition value="A plan or proposal that is fulfilled in whole or in part by this request." />
      <comment value="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 value="Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon." />
      <alias value="fulfills" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="CommunicationRequest.basedOn" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.basedOn" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=FLFS].target" />
      </mapping>
    </element>
    <element id="CommunicationRequest.replaces">
      <path value="CommunicationRequest.replaces" />
      <short value="Request(s) replaced by this request" />
      <definition value="Completed or terminated request(s) whose function is taken by this new request." />
      <comment value="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 value="Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests." />
      <alias value="supersedes" />
      <alias value="prior" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="CommunicationRequest.replaces" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CommunicationRequest" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.replaces" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=RPLC].target" />
      </mapping>
    </element>
    <element id="CommunicationRequest.groupIdentifier">
      <path value="CommunicationRequest.groupIdentifier" />
      <short value="Composite request this is part of" />
      <definition value="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 value="Requests are linked either by a &quot;basedOn&quot; 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 value="grouperId" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="CommunicationRequest.groupIdentifier" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Identifier" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ident-1" />
        <severity value="warning" />
        <human value="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="value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Identifier" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="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]" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="Identifier" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.groupIdentifier" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".inboundRelationship(typeCode=COMP].source[moodCode=INT].identifier" />
      </mapping>
    </element>
    <element id="CommunicationRequest.status">
      <path value="CommunicationRequest.status" />
      <short value="draft | active | on-hold | revoked | completed | entered-in-error | unknown" />
      <definition value="The status of the proposal or order." />
      <comment value="Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size" />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="CommunicationRequest.status" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <isModifier value="true" />
      <isModifierReason value="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 value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="CommunicationRequestStatus" />
        </extension>
        <strength value="required" />
        <description value="The status of the communication request." />
        <valueSet value="http://hl7.org/fhir/ValueSet/request-status|5.0.0" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.status" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.status" />
      </mapping>
    </element>
    <element id="CommunicationRequest.statusReason">
      <path value="CommunicationRequest.statusReason" />
      <short value="Reason for current status" />
      <definition value="Captures the reason for the current state of the CommunicationRequest." />
      <comment value="This is generally only used for &quot;exception&quot; statuses such as &quot;on-hold&quot; or &quot;revoked&quot;.  The reason why the CommunicationRequest was created at all is captured in reasonCode, not here." />
      <alias value="Suspended Reason" />
      <alias value="Cancelled Reason" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="CommunicationRequest.statusReason" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="CommunicationRequestStatusReason" />
        </extension>
        <strength value="example" />
        <description value="Codes identifying the reason for the current state of a request." />
        <valueSet value="http://hl7.org/fhir/ValueSet/communication-request-status-reason" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.statusReason" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde" />
      </mapping>
    </element>
    <element id="CommunicationRequest.intent">
      <path value="CommunicationRequest.intent" />
      <short value="proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option" />
      <definition value="Indicates the level of authority/intentionality associated with the CommunicationRequest and where the request fits into the workflow chain." />
      <comment value="This element is expected to be immutable.  E.g. A &quot;proposal&quot; instance should never change to be a &quot;plan&quot; instance or &quot;order&quot; instance.  Instead, a new instance 'basedOn' the prior instance should be created with the new 'intent' value.&#xA;&#xA;One exception to this is that the granularity of CommunicationRequest.intent is allowed to change.  For example, a Request identified as an &quot;order&quot; might later be clarified to be a &quot;filler-order&quot;.  Or, in rarer cases (to meet recipient constraints), the reverse might also occur." />
      <requirements value="Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="CommunicationRequest.intent" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="true" />
      <isModifierReason value="This element changes the interpretation of all descriptive attributes. For example &quot;the time the request is recommended to occur&quot; vs. &quot;the time the request is authorized to occur&quot; or &quot;who is recommended to perform the request&quot; vs. &quot;who is authorized to perform the request" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="CommunicationRequestIntent" />
        </extension>
        <strength value="required" />
        <description value="Codes indicating the degree of authority/intentionality associated with a request." />
        <valueSet value="http://hl7.org/fhir/ValueSet/request-intent|5.0.0" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.intent" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.class" />
      </mapping>
    </element>
    <element id="CommunicationRequest.category">
      <path value="CommunicationRequest.category" />
      <short value="Message category" />
      <definition value="The type of message to be sent such as alert, notification, reminder, instruction, etc." />
      <comment value="There may be multiple axes of categorization and one communication request may serve multiple purposes." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="CommunicationRequest.category" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="CommunicationCategory" />
        </extension>
        <strength value="example" />
        <description value="Codes for general categories of communications such as alerts, instruction, etc." />
        <valueSet value="http://hl7.org/fhir/ValueSet/communication-category" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.class" />
      </mapping>
    </element>
    <element id="CommunicationRequest.priority">
      <path value="CommunicationRequest.priority" />
      <short value="routine | urgent | asap | stat" />
      <definition value="Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routine." />
      <comment value="Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="CommunicationRequest.priority" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <meaningWhenMissing value="If missing, this task should be performed with normal priority" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="CommunicationPriority" />
        </extension>
        <strength value="required" />
        <description value="Codes indicating the relative importance of a communication request." />
        <valueSet value="http://hl7.org/fhir/ValueSet/request-priority|5.0.0" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.priority" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.grade" />
      </mapping>
    </element>
    <element id="CommunicationRequest.doNotPerform">
      <path value="CommunicationRequest.doNotPerform" />
      <short value="True if request is prohibiting action" />
      <definition value="If true indicates that the CommunicationRequest is asking for the specified action to *not* occur." />
      <comment value="The attributes provided with the request qualify what is not to be done." />
      <alias value="prohibited" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="CommunicationRequest.doNotPerform" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <meaningWhenMissing value="If do not perform is not specified, the request is a positive request e.g. &quot;do perform&quot;" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="true" />
      <isModifierReason value="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 value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.doNotPerform" />
      </mapping>
    </element>
    <element id="CommunicationRequest.medium">
      <path value="CommunicationRequest.medium" />
      <short value="A channel of communication" />
      <definition value="A channel that was used for this communication (e.g. email, fax)." />
      <comment value="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 value="0" />
      <max value="*" />
      <base>
        <path value="CommunicationRequest.medium" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="CommunicationMedium" />
        </extension>
        <strength value="extensible" />
        <description value="Codes for communication mediums such as phone, fax, email, in person, etc." />
        <valueSet value="https://fhir.nhs.uk/ValueSet/Spine-CommunicationChannel-vs" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
    </element>
    <element id="CommunicationRequest.subject">
      <path value="CommunicationRequest.subject" />
      <short value="Focus of message" />
      <definition value="The patient or group that is the focus of this communication request.&#xD;&#xA;&#xD;&#xA;```json&#xD;&#xA;&quot;subject&quot;: {&#xD;&#xA;        &quot;type&quot;: &quot;Patient&quot;,&#xD;&#xA;        &quot;identifier&quot;: {&#xD;&#xA;            &quot;system&quot;: &quot;https://fhir.nhs.uk/Id/nhs-number&quot;,&#xD;&#xA;            &quot;value&quot;: &quot;9453740519&quot;&#xD;&#xA;        }&#xD;&#xA;    }&#xD;&#xA;```" />
      <comment value="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 value="patient" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="CommunicationRequest.subject" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="patient-reference" />
        <severity value="warning" />
        <human value="subject - An identifier reference plus a display name or resource reference must be provided" />
        <expression value="(reference.exists() or (identifier.exists() and display.exists()))" />
        <source value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-CommunicationRequest" />
      </constraint>
      <constraint>
        <key value="patient-nhs" />
        <severity value="error" />
        <human value="Supplied NHS Number is outside the English and Welsh NHS Number range or length of the number is wrong." />
        <expression value="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 value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-CommunicationRequest" />
      </constraint>
      <mustSupport value="true" />
      <isModifier value="false" />
      <isSummary value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.subject" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.subject[x]" />
      </mapping>
    </element>
    <element id="CommunicationRequest.subject.id">
      <path value="CommunicationRequest.subject.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <condition value="ele-1" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="CommunicationRequest.subject.extension">
      <path value="CommunicationRequest.subject.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="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 value="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 value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.subject.reference">
      <path value="CommunicationRequest.subject.reference" />
      <short value="Literal reference, Relative, internal or absolute URL" />
      <definition value="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 value="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 &quot;[type]/[id]&quot; then it should be assumed that the reference is to a FHIR RESTful server." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Reference.reference" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ref-2" />
      <condition value="ref-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.subject.type">
      <path value="CommunicationRequest.subject.type" />
      <short value="Type the reference refers to (e.g. &quot;Patient&quot;) - must be a resource in resources" />
      <definition value="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.&#xA;&#xA;The 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. &quot;Patient&quot; 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 value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Reference.type" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueString value="Aa resource (or, for logical models, the URI of the logical model)." />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="FHIRResourceTypeExt" />
        </extension>
        <strength value="extensible" />
        <description value="Aa resource (or, for logical models, the URI of the logical model)." />
        <valueSet value="http://hl7.org/fhir/ValueSet/resource-types" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.subject.identifier">
      <path value="CommunicationRequest.subject.identifier" />
      <short value="Logical reference, when literal reference is not known" />
      <definition value="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 value="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. &#xA;&#xA;When 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&#xA;&#xA;Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.&#xA;&#xA;Reference 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).&#xA;&#xA;This 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 value="0" />
      <max value="1" />
      <base>
        <path value="Reference.identifier" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Identifier" />
      </type>
      <condition value="ref-2" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ident-1" />
        <severity value="warning" />
        <human value="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="value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Identifier" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="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]" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="Identifier" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".identifier" />
      </mapping>
    </element>
    <element id="CommunicationRequest.subject.identifier.id">
      <path value="CommunicationRequest.subject.identifier.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <condition value="ele-1" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="CommunicationRequest.subject.identifier.extension">
      <path value="CommunicationRequest.subject.identifier.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="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 value="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 value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.subject.identifier.use">
      <path value="CommunicationRequest.subject.identifier.use" />
      <short value="usual | official | temp | secondary | old (If known)" />
      <definition value="The purpose of this identifier." />
      <comment value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
      <requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.use" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one." />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueString value="Identifies the purpose for this identifier, if known ." />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierUse" />
        </extension>
        <strength value="required" />
        <description value="Identifies the purpose for this identifier, if known ." />
        <valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|5.0.0" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.code or implied by context" />
      </mapping>
    </element>
    <element id="CommunicationRequest.subject.identifier.type">
      <path value="CommunicationRequest.subject.identifier.type" />
      <short value="Description of identifier" />
      <definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
      <comment value="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 value="Allows users to make use of identifiers when the identifier system is not known." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.type" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueString value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierType" />
        </extension>
        <strength value="extensible" />
        <description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
        <valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.5" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.code or implied by context" />
      </mapping>
    </element>
    <element id="CommunicationRequest.subject.identifier.system">
      <path value="CommunicationRequest.subject.identifier.system" />
      <short value="The namespace for the identifier value" />
      <definition value="Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique." />
      <comment value="Identifier.system is always case sensitive." />
      <requirements value="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 value="1" />
      <max value="1" />
      <base>
        <path value="Identifier.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <example>
        <label value="General" />
        <valueUri value="http://www.acme.com/identifiers/patient" />
      </example>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.4 / EI-2-4" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.root or Role.id.root" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./IdentifierType" />
      </mapping>
    </element>
    <element id="CommunicationRequest.subject.identifier.value">
      <path value="CommunicationRequest.subject.identifier.value" />
      <short value="The value that is unique" />
      <definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
      <comment value="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 value="1" />
      <max value="1" />
      <base>
        <path value="Identifier.value" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <example>
        <label value="General" />
        <valueString value="123456" />
      </example>
      <condition value="ident-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.1 / EI.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./Value" />
      </mapping>
    </element>
    <element id="CommunicationRequest.subject.identifier.period">
      <path value="CommunicationRequest.subject.identifier.period" />
      <short value="Time period when id is/was valid for use" />
      <definition value="Time period during which identifier is/was valid for use." />
      <comment value="A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. &quot;the patient was an inpatient of the hospital for this time range&quot;) or one value from the range applies (e.g. &quot;give to the patient between these two times&quot;).&#xA;&#xA;Period is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.period" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Period" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="per-1" />
        <severity value="error" />
        <human value="If present, start SHALL have a lower or equal value than end" />
        <expression value="start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() &lt;= end.highBoundary())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Period" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="DR" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="IVL&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;] or URG&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;]" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.7 + CX.8" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.effectiveTime or implied by context" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./StartDate and ./EndDate" />
      </mapping>
    </element>
    <element id="CommunicationRequest.subject.identifier.assigner">
      <path value="CommunicationRequest.subject.identifier.assigner" />
      <short value="Organization that issued id (may be just text)" />
      <definition value="Organization that issued/manages the identifier." />
      <comment value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.assigner" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.4 / (CX.4,CX.9,CX.10)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./IdentifierIssuingAuthority" />
      </mapping>
    </element>
    <element id="CommunicationRequest.subject.display">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true" />
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true" />
      </extension>
      <path value="CommunicationRequest.subject.display" />
      <short value="Text alternative for the resource" />
      <definition value="Plain text narrative that identifies the resource in addition to the resource reference." />
      <comment value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Reference.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ref-2" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.about">
      <path value="CommunicationRequest.about" />
      <short value="Resources that pertain to this communication request" />
      <definition value="Other resources that pertain to this communication request and to which this communication request should be associated." />
      <comment value="Don't use CommunicationRequest.about element when a more specific element exists, such as basedOn, reasonReference, or replaces." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="CommunicationRequest.about" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.supportingInfo" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.context" />
      </mapping>
    </element>
    <element id="CommunicationRequest.encounter">
      <path value="CommunicationRequest.encounter" />
      <short value="The Encounter during which this CommunicationRequest was created" />
      <definition value="The Encounter during which this CommunicationRequest was created or to which the creation of this record is tightly associated." />
      <comment value="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 value="0" />
      <max value="1" />
      <base>
        <path value="CommunicationRequest.encounter" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.encounter" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.context" />
      </mapping>
    </element>
    <element id="CommunicationRequest.payload">
      <path value="CommunicationRequest.payload" />
      <short value="Message payload" />
      <definition value="#### NHSApp&#xD;&#xA;&#xD;&#xA;**In App Messages** &#xD;&#xA;&#xD;&#xA;NHSApp supports a subset of Markdown for in-app messages, please see API documentation for more details. Only `contentString` is supported.&#xD;&#xA;&#xD;&#xA;```json&#xD;&#xA;  &#xD;&#xA;    &quot;payload&quot;:  [&#xD;&#xA;        {&#xD;&#xA;            &quot;contentString&quot;: &quot;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)&quot;&#xD;&#xA;        }&#xD;&#xA;    ]&#xD;&#xA;```&#xD;&#xA;&#xD;&#xA;**Push Notifications**&#xD;&#xA;&#xD;&#xA;Only `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.&#xD;&#xA;&#xD;&#xA;```json&#xD;&#xA;  &#xD;&#xA;    &quot;payload&quot;:  [&#xD;&#xA;        {&#xD;&#xA;            &quot;contentReference&quot;: {&#xD;&#xA;                &quot;reference&quot;: &quot;https://www.nhsapp.service.nhs.uk/patient/messages/app-messaging&quot;,&#xD;&#xA;                &quot;display&quot;: &quot;You have a new message. The message may contain something important.&quot;&#xD;&#xA;            }&#xD;&#xA;        }&#xD;&#xA;    ],&#xD;&#xA;```&#xD;&#xA;&#xD;&#xA;#### EPS&#xD;&#xA;&#xD;&#xA;**CommunicationRequest** is used in Electronic Prescription Service (EPS) to convey patient specific information. This includes:&#xD;&#xA;&#xD;&#xA;* patient information - messages to the patient&#xD;&#xA;* 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`&#xD;&#xA;&#xD;&#xA;These would be traditionally printed on the right hand side of the FP10 stationery.&#xD;&#xA;&#xD;&#xA;**CommunicationRequest should not contain Clinical information regarding the prescriptions, these should be conveyed in the MedicationRequest resource.**&#xD;&#xA;&#xD;&#xA;```json&#xD;&#xA;&#xD;&#xA;    &quot;payload&quot;:  [&#xD;&#xA;        {&#xD;&#xA;            &quot;contentString&quot;: &quot;Please make an appointment to see your GP. Review date due&quot;&#xD;&#xA;        },&#xD;&#xA;        {&#xD;&#xA;            &quot;contentReference&quot;: {&#xD;&#xA;                &quot;reference&quot;: &quot;urn:uuid:d0f003a0-8763-43d5-a264-ce52a38901c9&quot;,&#xD;&#xA;                &quot;display&quot;: &quot;List of Repeat Medications for re-ordering&quot;&#xD;&#xA;            }&#xD;&#xA;        }&#xD;&#xA;    ],&#xD;&#xA;```" />
      <comment value="The payload will consist of message to the Patient and/or a reference to a list of active repeat medications." />
      <min value="1" />
      <max value="*" />
      <base>
        <path value="CommunicationRequest.payload" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <isModifier value="false" />
      <isSummary value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="CommunicationRequest.payload.id">
      <path value="CommunicationRequest.payload.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <condition value="ele-1" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="CommunicationRequest.payload.extension">
      <path value="CommunicationRequest.payload.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="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 value="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 value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.payload.extension:deviceContent">
      <path value="CommunicationRequest.payload.extension" />
      <sliceName value="deviceContent" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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 value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.nhs.uk/StructureDefinition/Extension-Spine-CommunicationPayload" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.payload.modifierExtension">
      <path value="CommunicationRequest.payload.modifierExtension" />
      <short value="Extensions that cannot be ignored even if unrecognized" />
      <definition value="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.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
      <comment value="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 value="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 value="extensions" />
      <alias value="user content" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="BackboneElement.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.payload.content[x]">
      <path value="CommunicationRequest.payload.content[x]" />
      <short value="Message part content" />
      <definition value="The communicated content (or for multi-part communications, one portion of the communication)." />
      <comment value="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.&#xA;&#xA;If the content isn't codified, contentCodeableConcept.text can be used.  &#xA;&#xA;When using contentCodeableConcept, the CodeableConcept is what is being communicated and is not a categorization of the content." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="CommunicationRequest.payload.content[x]" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="Attachment" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
      </type>
      <type>
        <code value="CodeableConcept" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.note" />
      </mapping>
    </element>
    <element id="CommunicationRequest.occurrence[x]">
      <path value="CommunicationRequest.occurrence[x]" />
      <short value="When scheduled" />
      <definition value="The time when this communication is to occur." />
      <alias value="timing" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="CommunicationRequest.occurrence[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <type>
        <code value="Period" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.occurrence[x]" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.planned" />
      </mapping>
    </element>
    <element id="CommunicationRequest.authoredOn">
      <path value="CommunicationRequest.authoredOn" />
      <short value="When request transitioned to being actionable" />
      <definition value="For draft requests, indicates the date of initial creation.  For requests with other statuses, indicates the date of activation." />
      <comment value="UTC offset is allowed for dates and partial dates" />
      <alias value="createdOn" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="CommunicationRequest.authoredOn" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.authoredOn" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.recorded" />
      </mapping>
    </element>
    <element id="CommunicationRequest.requester">
      <path value="CommunicationRequest.requester" />
      <short value="Who asks for the information to be shared" />
      <definition value="The person/organisation making the communication request. This **SHOULD** use reference identifiers.&#xD;&#xA;&#xD;&#xA;```json&#xD;&#xA;&#xD;&#xA;    &quot;requester&quot;: {&#xD;&#xA;        &quot;type&quot;: &quot;Organization&quot;,&#xD;&#xA;        &quot;identifier&quot;: {&#xD;&#xA;            &quot;system&quot;: &quot;https://fhir.nhs.uk/Id/ods-organization-code&quot;,&#xD;&#xA;            &quot;value&quot;: &quot;RBA&quot;&#xD;&#xA;        },&#xD;&#xA;        &quot;display&quot;: &quot;TAUNTON AND SOMERSET NHS FOUNDATION TRUST&quot;&#xD;&#xA;    },&#xD;&#xA;```" />
      <comment value="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 value="author" />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="CommunicationRequest.requester" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient" />
        <targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole" />
        <targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-Organization" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mustSupport value="true" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.requester" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.author" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=AUT].role" />
      </mapping>
    </element>
    <element id="CommunicationRequest.requester.id">
      <path value="CommunicationRequest.requester.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <condition value="ele-1" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="CommunicationRequest.requester.extension">
      <path value="CommunicationRequest.requester.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="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 value="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 value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.requester.reference">
      <path value="CommunicationRequest.requester.reference" />
      <short value="Literal reference, Relative, internal or absolute URL" />
      <definition value="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 value="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 &quot;[type]/[id]&quot; then it should be assumed that the reference is to a FHIR RESTful server." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Reference.reference" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ref-2" />
      <condition value="ref-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.requester.type">
      <path value="CommunicationRequest.requester.type" />
      <short value="Type the reference refers to (e.g. &quot;Patient&quot;) - must be a resource in resources" />
      <definition value="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.&#xA;&#xA;The 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. &quot;Patient&quot; 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 value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Reference.type" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueString value="Aa resource (or, for logical models, the URI of the logical model)." />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="FHIRResourceTypeExt" />
        </extension>
        <strength value="extensible" />
        <description value="Aa resource (or, for logical models, the URI of the logical model)." />
        <valueSet value="http://hl7.org/fhir/ValueSet/resource-types" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.requester.identifier">
      <path value="CommunicationRequest.requester.identifier" />
      <short value="Logical reference, when literal reference is not known" />
      <definition value="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 value="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. &#xA;&#xA;When 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&#xA;&#xA;Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.&#xA;&#xA;Reference 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).&#xA;&#xA;This 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 value="0" />
      <max value="1" />
      <base>
        <path value="Reference.identifier" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Identifier" />
      </type>
      <condition value="ref-2" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ident-1" />
        <severity value="warning" />
        <human value="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="value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Identifier" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="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]" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="Identifier" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".identifier" />
      </mapping>
    </element>
    <element id="CommunicationRequest.requester.identifier.id">
      <path value="CommunicationRequest.requester.identifier.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <condition value="ele-1" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="CommunicationRequest.requester.identifier.extension">
      <path value="CommunicationRequest.requester.identifier.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="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 value="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 value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.requester.identifier.use">
      <path value="CommunicationRequest.requester.identifier.use" />
      <short value="usual | official | temp | secondary | old (If known)" />
      <definition value="The purpose of this identifier." />
      <comment value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
      <requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.use" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one." />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueString value="Identifies the purpose for this identifier, if known ." />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierUse" />
        </extension>
        <strength value="required" />
        <description value="Identifies the purpose for this identifier, if known ." />
        <valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|5.0.0" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.code or implied by context" />
      </mapping>
    </element>
    <element id="CommunicationRequest.requester.identifier.type">
      <path value="CommunicationRequest.requester.identifier.type" />
      <short value="Description of identifier" />
      <definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
      <comment value="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 value="Allows users to make use of identifiers when the identifier system is not known." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.type" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueString value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierType" />
        </extension>
        <strength value="extensible" />
        <description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
        <valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.5" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.code or implied by context" />
      </mapping>
    </element>
    <element id="CommunicationRequest.requester.identifier.system">
      <path value="CommunicationRequest.requester.identifier.system" />
      <short value="The namespace for the identifier value" />
      <definition value="Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique." />
      <comment value="Identifier.system is always case sensitive." />
      <requirements value="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 value="1" />
      <max value="1" />
      <base>
        <path value="Identifier.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <example>
        <label value="General" />
        <valueUri value="http://www.acme.com/identifiers/patient" />
      </example>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.4 / EI-2-4" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.root or Role.id.root" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./IdentifierType" />
      </mapping>
    </element>
    <element id="CommunicationRequest.requester.identifier.value">
      <path value="CommunicationRequest.requester.identifier.value" />
      <short value="The value that is unique" />
      <definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
      <comment value="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 value="1" />
      <max value="1" />
      <base>
        <path value="Identifier.value" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <example>
        <label value="General" />
        <valueString value="123456" />
      </example>
      <condition value="ident-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.1 / EI.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./Value" />
      </mapping>
    </element>
    <element id="CommunicationRequest.requester.identifier.period">
      <path value="CommunicationRequest.requester.identifier.period" />
      <short value="Time period when id is/was valid for use" />
      <definition value="Time period during which identifier is/was valid for use." />
      <comment value="A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. &quot;the patient was an inpatient of the hospital for this time range&quot;) or one value from the range applies (e.g. &quot;give to the patient between these two times&quot;).&#xA;&#xA;Period is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.period" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Period" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="per-1" />
        <severity value="error" />
        <human value="If present, start SHALL have a lower or equal value than end" />
        <expression value="start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() &lt;= end.highBoundary())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Period" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="DR" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="IVL&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;] or URG&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;]" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.7 + CX.8" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.effectiveTime or implied by context" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./StartDate and ./EndDate" />
      </mapping>
    </element>
    <element id="CommunicationRequest.requester.identifier.assigner">
      <path value="CommunicationRequest.requester.identifier.assigner" />
      <short value="Organization that issued id (may be just text)" />
      <definition value="Organization that issued/manages the identifier." />
      <comment value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.assigner" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.4 / (CX.4,CX.9,CX.10)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./IdentifierIssuingAuthority" />
      </mapping>
    </element>
    <element id="CommunicationRequest.requester.display">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true" />
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true" />
      </extension>
      <path value="CommunicationRequest.requester.display" />
      <short value="Text alternative for the resource" />
      <definition value="Plain text narrative that identifies the resource in addition to the resource reference." />
      <comment value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Reference.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ref-2" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.recipient">
      <path value="CommunicationRequest.recipient" />
      <short value="Who to share the information with" />
      <definition value="The persons/organisations who will receive the communication request. This **SHOULD** use reference identifiers.&#xD;&#xA;&#xD;&#xA;```json&#xD;&#xA;&#xD;&#xA;    &quot;recipient&quot;:  [&#xD;&#xA;        {&#xD;&#xA;            &quot;type&quot;: &quot;Patient&quot;,&#xD;&#xA;            &quot;identifier&quot;: {&#xD;&#xA;                &quot;system&quot;: &quot;https://fhir.nhs.uk/Id/nhs-number&quot;,&#xD;&#xA;                &quot;value&quot;: &quot;9453740519&quot;&#xD;&#xA;            }&#xD;&#xA;        }&#xD;&#xA;    ]&#xD;&#xA;```" />
      <comment value="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 value="1" />
      <max value="*" />
      <base>
        <path value="CommunicationRequest.recipient" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam" />
        <targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-Organization" />
        <targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient" />
        <targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-Practitioner" />
        <targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole" />
        <targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-HealthcareService" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mustSupport value="true" />
      <isModifier value="false" />
      <isSummary value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.performer" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.actor" />
      </mapping>
    </element>
    <element id="CommunicationRequest.recipient.id">
      <path value="CommunicationRequest.recipient.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <condition value="ele-1" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="CommunicationRequest.recipient.extension">
      <path value="CommunicationRequest.recipient.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="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 value="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 value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.recipient.reference">
      <path value="CommunicationRequest.recipient.reference" />
      <short value="Literal reference, Relative, internal or absolute URL" />
      <definition value="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 value="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 &quot;[type]/[id]&quot; then it should be assumed that the reference is to a FHIR RESTful server." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Reference.reference" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ref-2" />
      <condition value="ref-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.recipient.type">
      <path value="CommunicationRequest.recipient.type" />
      <short value="Type the reference refers to (e.g. &quot;Patient&quot;) - must be a resource in resources" />
      <definition value="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.&#xA;&#xA;The 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. &quot;Patient&quot; 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 value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Reference.type" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueString value="Aa resource (or, for logical models, the URI of the logical model)." />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="FHIRResourceTypeExt" />
        </extension>
        <strength value="extensible" />
        <description value="Aa resource (or, for logical models, the URI of the logical model)." />
        <valueSet value="http://hl7.org/fhir/ValueSet/resource-types" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.recipient.identifier">
      <path value="CommunicationRequest.recipient.identifier" />
      <short value="Logical reference, when literal reference is not known" />
      <definition value="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 value="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. &#xA;&#xA;When 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&#xA;&#xA;Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.&#xA;&#xA;Reference 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).&#xA;&#xA;This 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 value="0" />
      <max value="1" />
      <base>
        <path value="Reference.identifier" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Identifier" />
      </type>
      <condition value="ref-2" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ident-1" />
        <severity value="warning" />
        <human value="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="value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Identifier" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="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]" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="Identifier" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".identifier" />
      </mapping>
    </element>
    <element id="CommunicationRequest.recipient.identifier.id">
      <path value="CommunicationRequest.recipient.identifier.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <condition value="ele-1" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="CommunicationRequest.recipient.identifier.extension">
      <path value="CommunicationRequest.recipient.identifier.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="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 value="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 value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.recipient.identifier.use">
      <path value="CommunicationRequest.recipient.identifier.use" />
      <short value="usual | official | temp | secondary | old (If known)" />
      <definition value="The purpose of this identifier." />
      <comment value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
      <requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.use" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one." />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueString value="Identifies the purpose for this identifier, if known ." />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierUse" />
        </extension>
        <strength value="required" />
        <description value="Identifies the purpose for this identifier, if known ." />
        <valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|5.0.0" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.code or implied by context" />
      </mapping>
    </element>
    <element id="CommunicationRequest.recipient.identifier.type">
      <path value="CommunicationRequest.recipient.identifier.type" />
      <short value="Description of identifier" />
      <definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
      <comment value="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 value="Allows users to make use of identifiers when the identifier system is not known." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.type" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueString value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierType" />
        </extension>
        <strength value="extensible" />
        <description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
        <valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.5" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.code or implied by context" />
      </mapping>
    </element>
    <element id="CommunicationRequest.recipient.identifier.system">
      <path value="CommunicationRequest.recipient.identifier.system" />
      <short value="The namespace for the identifier value" />
      <definition value="Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique." />
      <comment value="Identifier.system is always case sensitive." />
      <requirements value="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 value="1" />
      <max value="1" />
      <base>
        <path value="Identifier.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <example>
        <label value="General" />
        <valueUri value="http://www.acme.com/identifiers/patient" />
      </example>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.4 / EI-2-4" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.root or Role.id.root" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./IdentifierType" />
      </mapping>
    </element>
    <element id="CommunicationRequest.recipient.identifier.value">
      <path value="CommunicationRequest.recipient.identifier.value" />
      <short value="The value that is unique" />
      <definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
      <comment value="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 value="1" />
      <max value="1" />
      <base>
        <path value="Identifier.value" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <example>
        <label value="General" />
        <valueString value="123456" />
      </example>
      <condition value="ident-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.1 / EI.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./Value" />
      </mapping>
    </element>
    <element id="CommunicationRequest.recipient.identifier.period">
      <path value="CommunicationRequest.recipient.identifier.period" />
      <short value="Time period when id is/was valid for use" />
      <definition value="Time period during which identifier is/was valid for use." />
      <comment value="A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. &quot;the patient was an inpatient of the hospital for this time range&quot;) or one value from the range applies (e.g. &quot;give to the patient between these two times&quot;).&#xA;&#xA;Period is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.period" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Period" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="per-1" />
        <severity value="error" />
        <human value="If present, start SHALL have a lower or equal value than end" />
        <expression value="start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() &lt;= end.highBoundary())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Period" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="DR" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="IVL&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;] or URG&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;]" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.7 + CX.8" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.effectiveTime or implied by context" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./StartDate and ./EndDate" />
      </mapping>
    </element>
    <element id="CommunicationRequest.recipient.identifier.assigner">
      <path value="CommunicationRequest.recipient.identifier.assigner" />
      <short value="Organization that issued id (may be just text)" />
      <definition value="Organization that issued/manages the identifier." />
      <comment value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.assigner" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.4 / (CX.4,CX.9,CX.10)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./IdentifierIssuingAuthority" />
      </mapping>
    </element>
    <element id="CommunicationRequest.recipient.display">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true" />
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true" />
      </extension>
      <path value="CommunicationRequest.recipient.display" />
      <short value="Text alternative for the resource" />
      <definition value="Plain text narrative that identifies the resource in addition to the resource reference." />
      <comment value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Reference.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ref-2" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="CommunicationRequest.informationProvider">
      <path value="CommunicationRequest.informationProvider" />
      <short value="Who should share the information" />
      <definition value="The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication." />
      <comment value="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 value="0" />
      <max value="*" />
      <base>
        <path value="CommunicationRequest.informationProvider" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/HealthcareService" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Endpoint" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.performer" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.actor" />
      </mapping>
    </element>
    <element id="CommunicationRequest.reason">
      <path value="CommunicationRequest.reason" />
      <short value="Why is communication needed?" />
      <definition value="Describes why the request is being made in coded or textual form." />
      <comment value="Textual reasons can be captured using reasonCode.text." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="CommunicationRequest.reason" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableReference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="CommunicationReason" />
        </extension>
        <strength value="example" />
        <description value="Codes for describing reasons for the occurrence of a communication." />
        <valueSet value="http://terminology.hl7.org/ValueSet/v3-ActReason" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.reason" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.why[x]" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".reasonCode" />
      </mapping>
    </element>
    <element id="CommunicationRequest.note">
      <path value="CommunicationRequest.note" />
      <short value="Comments made about communication request" />
      <definition value="Comments made about the request by the requester, sender, recipient, subject or other participants." />
      <comment value="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 &quot;modifying&quot; information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible)." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="CommunicationRequest.note" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Annotation" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Act" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Request.note" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".inboundRelationship(typeCode=SUBJ].source[classCode=ANNGEN, moodCode=EVN].value[xsi:type=ST]" />
      </mapping>
    </element>
    <element id="CommunicationRequest.sender">
      <path value="CommunicationRequest.sender" />
      <base>
        <path value="CommunicationRequest.sender" />
      </base>
    </element>
    <element id="CommunicationRequest.reasonCode">
      <path value="CommunicationRequest.reasonCode" />
      <base>
        <path value="CommunicationRequest.reasonCode" />
      </base>
    </element>
  </snapshot>
  <differential>
    <element id="CommunicationRequest.status">
      <path value="CommunicationRequest.status" />
      <mustSupport value="true" />
    </element>
    <element id="CommunicationRequest.medium">
      <path value="CommunicationRequest.medium" />
      <binding>
        <strength value="extensible" />
        <valueSet value="https://fhir.nhs.uk/ValueSet/Spine-CommunicationChannel-vs" />
      </binding>
    </element>
    <element id="CommunicationRequest.subject">
      <path value="CommunicationRequest.subject" />
      <definition value="The patient or group that is the focus of this communication request.&#xD;&#xA;&#xD;&#xA;```json&#xD;&#xA;&quot;subject&quot;: {&#xD;&#xA;        &quot;type&quot;: &quot;Patient&quot;,&#xD;&#xA;        &quot;identifier&quot;: {&#xD;&#xA;            &quot;system&quot;: &quot;https://fhir.nhs.uk/Id/nhs-number&quot;,&#xD;&#xA;            &quot;value&quot;: &quot;9453740519&quot;&#xD;&#xA;        }&#xD;&#xA;    }&#xD;&#xA;```" />
      <type>
        <code value="Reference" />
        <targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient" />
      </type>
      <constraint>
        <key value="patient-reference" />
        <severity value="warning" />
        <human value="subject - An identifier reference plus a display name or resource reference must be provided" />
        <expression value="(reference.exists() or (identifier.exists() and display.exists()))" />
        <source value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-CommunicationRequest" />
      </constraint>
      <constraint>
        <key value="patient-nhs" />
        <severity value="error" />
        <human value="Supplied NHS Number is outside the English and Welsh NHS Number range or length of the number is wrong." />
        <expression value="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 value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-CommunicationRequest" />
      </constraint>
      <mustSupport value="true" />
    </element>
    <element id="CommunicationRequest.subject.identifier.system">
      <path value="CommunicationRequest.subject.identifier.system" />
      <min value="1" />
    </element>
    <element id="CommunicationRequest.subject.identifier.value">
      <path value="CommunicationRequest.subject.identifier.value" />
      <min value="1" />
    </element>
    <element id="CommunicationRequest.payload">
      <path value="CommunicationRequest.payload" />
      <definition value="#### NHSApp&#xD;&#xA;&#xD;&#xA;**In App Messages** &#xD;&#xA;&#xD;&#xA;NHSApp supports a subset of Markdown for in-app messages, please see API documentation for more details. Only `contentString` is supported.&#xD;&#xA;&#xD;&#xA;```json&#xD;&#xA;  &#xD;&#xA;    &quot;payload&quot;:  [&#xD;&#xA;        {&#xD;&#xA;            &quot;contentString&quot;: &quot;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)&quot;&#xD;&#xA;        }&#xD;&#xA;    ]&#xD;&#xA;```&#xD;&#xA;&#xD;&#xA;**Push Notifications**&#xD;&#xA;&#xD;&#xA;Only `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.&#xD;&#xA;&#xD;&#xA;```json&#xD;&#xA;  &#xD;&#xA;    &quot;payload&quot;:  [&#xD;&#xA;        {&#xD;&#xA;            &quot;contentReference&quot;: {&#xD;&#xA;                &quot;reference&quot;: &quot;https://www.nhsapp.service.nhs.uk/patient/messages/app-messaging&quot;,&#xD;&#xA;                &quot;display&quot;: &quot;You have a new message. The message may contain something important.&quot;&#xD;&#xA;            }&#xD;&#xA;        }&#xD;&#xA;    ],&#xD;&#xA;```&#xD;&#xA;&#xD;&#xA;#### EPS&#xD;&#xA;&#xD;&#xA;**CommunicationRequest** is used in Electronic Prescription Service (EPS) to convey patient specific information. This includes:&#xD;&#xA;&#xD;&#xA;* patient information - messages to the patient&#xD;&#xA;* 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`&#xD;&#xA;&#xD;&#xA;These would be traditionally printed on the right hand side of the FP10 stationery.&#xD;&#xA;&#xD;&#xA;**CommunicationRequest should not contain Clinical information regarding the prescriptions, these should be conveyed in the MedicationRequest resource.**&#xD;&#xA;&#xD;&#xA;```json&#xD;&#xA;&#xD;&#xA;    &quot;payload&quot;:  [&#xD;&#xA;        {&#xD;&#xA;            &quot;contentString&quot;: &quot;Please make an appointment to see your GP. Review date due&quot;&#xD;&#xA;        },&#xD;&#xA;        {&#xD;&#xA;            &quot;contentReference&quot;: {&#xD;&#xA;                &quot;reference&quot;: &quot;urn:uuid:d0f003a0-8763-43d5-a264-ce52a38901c9&quot;,&#xD;&#xA;                &quot;display&quot;: &quot;List of Repeat Medications for re-ordering&quot;&#xD;&#xA;            }&#xD;&#xA;        }&#xD;&#xA;    ],&#xD;&#xA;```" />
      <comment value="The payload will consist of message to the Patient and/or a reference to a list of active repeat medications." />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="CommunicationRequest.payload.extension">
      <path value="CommunicationRequest.payload.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <rules value="open" />
      </slicing>
      <min value="0" />
    </element>
    <element id="CommunicationRequest.payload.extension:deviceContent">
      <path value="CommunicationRequest.payload.extension" />
      <sliceName value="deviceContent" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.nhs.uk/StructureDefinition/Extension-Spine-CommunicationPayload" />
      </type>
    </element>
    <element id="CommunicationRequest.requester">
      <path value="CommunicationRequest.requester" />
      <definition value="The person/organisation making the communication request. This **SHOULD** use reference identifiers.&#xD;&#xA;&#xD;&#xA;```json&#xD;&#xA;&#xD;&#xA;    &quot;requester&quot;: {&#xD;&#xA;        &quot;type&quot;: &quot;Organization&quot;,&#xD;&#xA;        &quot;identifier&quot;: {&#xD;&#xA;            &quot;system&quot;: &quot;https://fhir.nhs.uk/Id/ods-organization-code&quot;,&#xD;&#xA;            &quot;value&quot;: &quot;RBA&quot;&#xD;&#xA;        },&#xD;&#xA;        &quot;display&quot;: &quot;TAUNTON AND SOMERSET NHS FOUNDATION TRUST&quot;&#xD;&#xA;    },&#xD;&#xA;```" />
      <min value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient" />
        <targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole" />
        <targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-Organization" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="CommunicationRequest.requester.identifier.system">
      <path value="CommunicationRequest.requester.identifier.system" />
      <min value="1" />
    </element>
    <element id="CommunicationRequest.requester.identifier.value">
      <path value="CommunicationRequest.requester.identifier.value" />
      <min value="1" />
    </element>
    <element id="CommunicationRequest.recipient">
      <path value="CommunicationRequest.recipient" />
      <definition value="The persons/organisations who will receive the communication request. This **SHOULD** use reference identifiers.&#xD;&#xA;&#xD;&#xA;```json&#xD;&#xA;&#xD;&#xA;    &quot;recipient&quot;:  [&#xD;&#xA;        {&#xD;&#xA;            &quot;type&quot;: &quot;Patient&quot;,&#xD;&#xA;            &quot;identifier&quot;: {&#xD;&#xA;                &quot;system&quot;: &quot;https://fhir.nhs.uk/Id/nhs-number&quot;,&#xD;&#xA;                &quot;value&quot;: &quot;9453740519&quot;&#xD;&#xA;            }&#xD;&#xA;        }&#xD;&#xA;    ]&#xD;&#xA;```" />
      <min value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam" />
        <targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-Organization" />
        <targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient" />
        <targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-Practitioner" />
        <targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole" />
        <targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-HealthcareService" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="CommunicationRequest.recipient.identifier.system">
      <path value="CommunicationRequest.recipient.identifier.system" />
      <min value="1" />
    </element>
    <element id="CommunicationRequest.recipient.identifier.value">
      <path value="CommunicationRequest.recipient.identifier.value" />
      <min value="1" />
    </element>
    <element id="CommunicationRequest.sender.identifier.system">
      <path value="CommunicationRequest.sender.identifier.system" />
      <min value="1" />
    </element>
    <element id="CommunicationRequest.sender.identifier.value">
      <path value="CommunicationRequest.sender.identifier.value" />
      <min value="1" />
    </element>
    <element id="CommunicationRequest.reasonCode">
      <path value="CommunicationRequest.reasonCode" />
      <binding>
        <strength value="preferred" />
        <description value="UKCore event types" />
        <valueSet value="https://fhir.nhs.uk/ValueSet/NHSDigital-message-events" />
      </binding>
    </element>
    <element id="CommunicationRequest.reasonCode.coding.system">
      <path value="CommunicationRequest.reasonCode.coding.system" />
      <min value="1" />
    </element>
    <element id="CommunicationRequest.reasonCode.coding.code">
      <path value="CommunicationRequest.reasonCode.coding.code" />
      <min value="1" />
    </element>
    <element id="CommunicationRequest.reasonCode.coding.display">
      <path value="CommunicationRequest.reasonCode.coding.display" />
      <min value="1" />
    </element>
  </differential>
</StructureDefinition>