<StructureDefinition xmlns="http://hl7.org/fhir">
  <meta>
    <lastUpdated value="2017-09-21T16:10:46.92+01:00" />
  </meta>
  <url value="https://fhir.nhs.uk/StructureDefinition/gpconnect-operationoutcome-1" />
  <version value="1.1.0" />
  <name value="GPConnect-OperationOutcome-1" />
  <display value="GPConnect-OperationOutcome-1" />
  <status value="active" />
  <publisher value="NHS Digital" />
  <contact>
    <name value="Interoperability Team" />
    <telecom>
      <system value="email" />
      <value value="interoperabilityteam@nhs.net" />
      <use value="work" />
    </telecom>
  </contact>
  <date value="2016-08-03T00:00:00+01:00" />
  <description value="The Operation Outcome resource supports a collection of error, warning or information messages that result from a GP Connect Query Request." />
  <copyright value="Copyright © 2017 Health and Social Care Information Centre" />
  <fhirVersion value="1.0.2" />
  <mapping>
    <identity value="v2" />
    <uri value="http://hl7.org/v2" />
    <name value="HL7 v2" />
  </mapping>
  <kind value="resource" />
  <constrainedType value="OperationOutcome" />
  <abstract value="false" />
  <base value="http://hl7.org/fhir/StructureDefinition/OperationOutcome" />
  <snapshot>
    <element>
      <path value="OperationOutcome" />
      <short value="Information about the success/failure of an action" />
      <definition value="A collection of error, warning or information messages that result from a system action." />
      <comments value="Can result from the failure of a REST call or be part of the response message returned from a request message.  If sent with extensions overriding particular issues, might even appear as part of a request message." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Resource" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="OperationOutcome" />
      </type>
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
        </extension>
        <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" />
        <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
      </constraint>
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="contained.where(('#'+id in %resource.descendants().reference).not()).empty()" />
        </extension>
        <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" />
        <xpath value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))" />
      </constraint>
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="contained.contained.empty()" />
        </extension>
        <key value="dom-2" />
        <severity value="error" />
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
        <xpath value="not(parent::f:contained and f:contained)" />
      </constraint>
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="contained.text.empty()" />
        </extension>
        <key value="dom-1" />
        <severity value="error" />
        <human value="If the resource is contained in another resource, it SHALL NOT contain any narrative" />
        <xpath value="not(parent::f:contained and f:text)" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="Entity. Role, or Act" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Grouping is handled through multiple repetitions from whatever context references the outcomes (no specific grouper required)" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="infrastructure.exchange" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.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." />
      <comments value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Bundles always have an id, though it is usually a generated UUID." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="id" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.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 may 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>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.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." />
      <comments 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 as much as possible." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.implicitRules" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isModifier value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.language" />
      <short value="Language of the resource content" />
      <definition value="The base language in which the resource is written." />
      <comments 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>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <binding>
        <strength value="required" />
        <description value="A human language." />
        <valueSetUri value="http://tools.ietf.org/html/bcp47" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.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 may 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." />
      <comments value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative." />
      <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="ele-1" />
      <condition value="dom-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <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>
      <path value="OperationOutcome.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, and nor can they have their own independent transaction scope." />
      <comments 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." />
      <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>
      <mapping>
        <identity value="rim" />
        <map value="Entity. Role, or Act" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.extension" />
      <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. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comments 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>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.modifierExtension" />
      <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. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." />
      <comments 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.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isModifier value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue" />
      <short value="A single issue associated with the action" />
      <definition value="An error, warning or information message that results from a system action." />
      <min value="1" />
      <max value="*" />
      <base>
        <path value="OperationOutcome.issue" />
        <min value="1" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="ERR" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="AcknowledgementDetail or Observation[classCode=&quot;ALRT&quot; and moodCode=&quot;EVN&quot;]" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.id" />
      <short value="xml:id (or equivalent in JSON)" />
      <definition value="unique id for the element within a resource (for internal references)." />
      <comments value="RFC 4122" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="id" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.extension" />
      <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. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comments 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>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.modifierExtension" />
      <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 element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." />
      <comments 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" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="BackboneElement.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isModifier value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.severity" />
      <short value="fatal | error | warning | information" />
      <definition value="Indicates whether the issue indicates a variation from successful processing." />
      <comments value="This is labeled as &quot;Is Modifier&quot; because applications should not confuse hints and warnings with errors." />
      <requirements value="Indicates how relevant the issue is to the overall success of the action." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="OperationOutcome.issue.severity" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isModifier value="true" />
      <isSummary value="true" />
      <binding>
        <strength value="required" />
        <description value="How the issue affects the success of the action." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/DSTU2/valueset-issue-severity.html" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="ERR-4" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./typeCode[parent::AcknowledgmentDetail] or unique(./inboundRelationship[parent::Observation and typeCode='SUBJ' and isNormalActRelationship()]/source[classCode=&quot;OBS&quot; and moodCode=&quot;EVN&quot; and implies(code, ActCode#SEV and isNormalAct())/value[xsi:type=&quot;CD&quot;]" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.code" />
      <label value=" " />
      <short value="Error or warning code" />
      <definition value="Describes the type of the issue." />
      <comments value="Note that FHIR strings may not exceed 1MB in size" />
      <requirements value="Expresses the issue in a human and computer-friendly way, allowing the requesting system to behave differently based on the type of issue. The system that creates an OperationOutcome SHALL choose the most applicable code from the IssueType value set, and may additional provide it's own codes in other coding elements in the type. A human readable description of the type of the issue SHOULD be placed in code.text." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="OperationOutcome.issue.code" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <strength value="required" />
        <description value="A code that describes the type of issue." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/issue-type" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="ERR-3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./code" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="ERR-3, ERR-5" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.details" />
      <short value="Spine Error or Warning Code" />
      <definition value="Additional details about the error. This may be a text description of the error, or a system code that identifies the error." />
      <comments value="A human readable description of the error issue SHOULD be placed in details.text." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="OperationOutcome.issue.details" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <strength value="required" />
        <description value="Spine error or warning code in response to a request." />
        <valueSetReference>
          <reference value="https://fhir.nhs.uk/ValueSet/spine-error-or-warning-code-1" />
        </valueSetReference>
      </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="ERR-5" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./code" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.details.id" />
      <short value="xml:id (or equivalent in JSON)" />
      <definition value="unique id for the element within a resource (for internal references)." />
      <comments value="RFC 4122" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="id" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.details.extension" />
      <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. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comments 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>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.details.coding" />
      <short value="Code defined by a terminology system" />
      <definition value="A reference to a code defined by a terminology system." />
      <comments value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true." />
      <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="CodeableConcept.coding" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="C*E.1-8, C*E.10-22" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="union(., ./translation)" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.details.coding.id" />
      <short value="xml:id (or equivalent in JSON)" />
      <definition value="unique id for the element within a resource (for internal references)." />
      <comments value="RFC 4122" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="id" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.details.coding.extension" />
      <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. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comments 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>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.details.coding.system" />
      <short value="GP Connect Error or Warning code" />
      <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
      <comments value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." />
      <requirements value="Need to be unambiguous about the source of the definition of the symbol." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <fixedUri value="https://fhir.nhs.uk/spine-error-or-warning-code-1" />
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="C*E.3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystem" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.details.coding.version" />
      <short value="Version of the system - if relevant" />
      <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
      <comments value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Coding.version" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="C*E.7" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystemVersion" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.details.coding.code" />
      <short value="Symbol in syntax defined by the system" />
      <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." />
      <comments value="Note that FHIR strings may not exceed 1MB in size" />
      <requirements value="Need to refer to a particular code in the system." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.code" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="C*E.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./code" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.details.coding.display" />
      <short value="Representation defined by the system" />
      <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
      <comments value="Note that FHIR strings may not exceed 1MB in size" />
      <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="C*E.2 - but note this is not well followed" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV.displayName" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.details.coding.userSelected" />
      <short value="If this coding was chosen directly by the user" />
      <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." />
      <comments value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." />
      <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Coding.userSelected" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="Sometimes implied by being first" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD.codingRationale" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.details.text" />
      <short value="Plain text representation of the GP Connect Error or Warning code" />
      <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." />
      <comments value="Very often the text is the same as a displayName of one of the codings." />
      <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="CodeableConcept.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="C*E.9. But note many systems use C*E.2 for this" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.diagnostics" />
      <short value="Additional diagnostic information about the issue" />
      <definition value="Additional diagnostic information about the issue.  Typically, this may be a description of how a value is erroneous, or a stack dump to help trace the issue." />
      <comments value="Typically this field is used to provide troubleshooting information about the error." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="OperationOutcome.issue.diagnostics" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="ERR-8" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./text[parent::AcknowledgmentDetail]" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.location" />
      <short value="XPath of element(s) related to issue" />
      <definition value="A simple XPath limited to element names, repetition indicators and the default child access that identifies one of the elements in the resource that caused this issue to be raised." />
      <comments value="The root of the XPath is the resource or bundle that generated OperationOutcome.  Each XPath SHALL resolve to a single node.  The XPath syntax is used whether the referenced instance is expressed in XML or JSON." />
      <requirements value="Allows systems to highlight or otherwise guide users to elements implicated in issues to allow them to be fixed more easily." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="OperationOutcome.issue.location" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="children()" />
        </extension>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="ERR-2" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./location[parent::AcknowledgmentDetail]" />
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element>
      <path value="OperationOutcome" />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="OperationOutcome" />
      </type>
    </element>
    <element>
      <path value="OperationOutcome.issue.severity" />
      <binding>
        <strength value="required" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/DSTU2/valueset-issue-severity.html" />
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="OperationOutcome.issue.code" />
      <label value=" " />
      <definition value="Describes the type of the issue." />
      <requirements value="Expresses the issue in a human and computer-friendly way, allowing the requesting system to behave differently based on the type of issue. The system that creates an OperationOutcome SHALL choose the most applicable code from the IssueType value set, and may additional provide it's own codes in other coding elements in the type. A human readable description of the type of the issue SHOULD be placed in code.text." />
      <mapping>
        <identity value="v2" />
        <map value="ERR-3, ERR-5" />
      </mapping>
    </element>
    <element>
      <path value="OperationOutcome.issue.details" />
      <short value="Spine Error or Warning Code" />
      <min value="1" />
      <binding>
        <strength value="required" />
        <description value="Spine error or warning code in response to a request." />
        <valueSetReference>
          <reference value="https://fhir.nhs.uk/ValueSet/spine-error-or-warning-code-1" />
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="OperationOutcome.issue.details.coding" />
      <min value="1" />
      <max value="1" />
    </element>
    <element>
      <path value="OperationOutcome.issue.details.coding.system" />
      <short value="GP Connect Error or Warning code" />
      <min value="1" />
      <fixedUri value="https://fhir.nhs.uk/spine-error-or-warning-code-1" />
    </element>
    <element>
      <path value="OperationOutcome.issue.details.coding.version" />
      <max value="0" />
    </element>
    <element>
      <path value="OperationOutcome.issue.details.coding.code" />
      <min value="1" />
    </element>
    <element>
      <path value="OperationOutcome.issue.details.coding.display" />
      <min value="1" />
    </element>
    <element>
      <path value="OperationOutcome.issue.details.coding.userSelected" />
      <max value="0" />
    </element>
    <element>
      <path value="OperationOutcome.issue.details.text" />
      <short value="Plain text representation of the GP Connect Error or Warning code" />
    </element>
    <element>
      <path value="OperationOutcome.issue.location" />
      <max value="1" />
    </element>
  </differential>
</StructureDefinition>