Panorama Immunization Registry

This Profile is created and maintained external to the LRA project and is provided here as an aid for implementers of the LRA in finding the base profile definitions. The reader should always verify the profile on the linked source page.

Overview

LRA integrates with the Panorama Immunization Registry (PIR) by consuming PIR-defined FHIR Bundles and persisting the included resources in the LRA Platform (Smile CDR). LRA does not create or maintain immunization profiles; implementers should treat the PIR Simplifier project as the source of truth for profile definitions and constraints.

Conformance

• All resources are expected to conform to PIR-defined profiles (HL7 FHIR R4 / 4.0.1).
• LRA preserves the PIR meta.profile declarations on persisted resources.

Persistence conventions

• Resources are persisted as individual FHIR resources in Smile CDR.
• MessageHeader is not persisted (used for ingestion/message context only).
• Resources with contained resources (e.g., Consent, CarePlan) are stored as a single resource (outer + contained content). (need to fix the language)

LRA metadata additions on persisted resources

• meta.source captures the original PIR Bundle ID (traceability back to PIR).
• meta.tag includes an LRA source-system tag (e.g., PIR = Provincial Immunization Registry) to support filtering/partitioning.

Logical ID strategy

• LRA uses PIR logical IDs but prefixes them for uniqueness across LRA domains.
  • Example: id = "PIR-462321729"
• LRA uses PIR-assigned logical IDs and applies a source prefix for uniqueness, rather than using Smile CDR auto-generated IDs, to preserve a consistent, traceable mapping back to PIR-originated records.
  

Query and Retrieval Guidance

There are several ways to retrieve Immunization resources and their related context resources from the LRA platform.

In the current release, implementers typically begin with a Patient search using a BC PHN, then use a set of FHIR reverse-includes (_revinclude) to retrieve associated immunization-related resources linked to that patient.

Note: To retrieve the full immunization longitudinal record for a patient, see the Unified Immunization Query section below.

Search by Patient Identifier (PHN)

The following search parameters and search parameter combinations SHALL be supported.

The system SHALL support searching for a Patient by identifier, such as a BC PHN, using the identifier and tag search parameters:

GET [base]/Patient?identifier={system|}[code]&_tag=http://phsa.ca/fhir/lra/CodeSystem/source-system|PIR

Example:

GET [base]/Patient?identifier=https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-patient-healthcare-id|9872728523&_tag=http://phsa.ca/fhir/lra/CodeSystem/source-system|PIR

Search by Reverse-Include Immunization Context Resources

After locating the correct Patient, the system SHALL support retrieving immunization-related resources using the _revinclude parameter via the Patient search.

The following reverse-include relationships SHALL be supported:

The Unified Immunization Query example below shows only the reverse-included resources that are fully supported in the current release. Additional related resources, such as Location and Organization, may be enabled in a future release once their references are populated.

Unified Immunization Query

The system SHALL support retrieving the immunization longitudinal record using a Patient BC PHN.

GET [baseURL]/fhir/Patient?identifier={system|}[code]&_tag=http://phsa.ca/fhir/lra/CodeSystem/source-system|PIR&_revinclude=Immunization:patient&_revinclude=ImmunizationRecommendation:patient&_revinclude=AdverseEvent:subject&_revinclude=MedicationRequest:subject&_revinclude=RiskAssessment:subject&_revinclude=CarePlan:subject&_revinclude=Consent:patient

This query returns the Patient and all currently supported reverse-included immunization context resources associated with that patient within the PIR source domain.

ImmunizationRecommendation (Forecasts) by Last Updated

The system SHALL support retrieving ImmunizationRecommendation resources by _tag and _lastUpdated using a specific date/time.

_lastUpdated may be used with a single lower-bound timestamp for incremental retrieval, or with both lower-bound and upper-bound timestamps to define a time window.

Example: Incremental retrieval from a specific timestamp

GET [baseURL]/fhir/ImmunizationRecommendation?_lastUpdated=ge2026-02-25T00:00:00Z&_tag=http://phsa.ca/fhir/lra/CodeSystem/source-system|PIR

This query supports incremental retrieval of immunization forecast records that have been created or updated on or after the specified timestamp.

Example: Retrieval within a 1-hour window

GET [baseURL]/fhir/ImmunizationRecommendation?_lastUpdated=ge2026-03-08T06:09:34.084Z&_lastUpdated=lt2026-03-08T07:09:34.084Z&_tag=http://phsa.ca/fhir/lra/CodeSystem/source-system|PIR

This query retrieves ImmunizationRecommendation resources tagged with the source system PIR that were last updated within the specified 1-hour window.

• _lastUpdated=ge2026-03-08T06:09:34.084Z
  Retrieves ImmunizationRecommendation resources last updated on or after 2026-03-08T06:09:34.084Z.

• _lastUpdated=lt2026-03-08T07:09:34.084Z
  Retrieves ImmunizationRecommendation resources last updated before 2026-03-08T07:09:34.084Z.

Important Links

Simplifier Project Page: BCY Immunization Distribution Service

Example Usage Scenarios

Example Bundle: Example Bundle - Immunization

Profiles Content

The Panorama Immunization Registry (PIR) sends an immunization bundle whenever a patient's immunization data is updated or changed. This bundle represents the current view of the patient’s immunization status, and while it may include resources that are identical to those in previous bundles, it provides a complete replacement of the prior data for the patient.

The structure of the Immunization bundle includes the following resources:

• MessageHeader 1..1
• Patient 1..1
• Organization 1..*
• Location 1..*
• Immunization 1..*
• AdverseEvent 0..*
• Consent 0..*
• ImmunizationRecommendation 0..*
• RiskAssessment 0..*
• MedicationRequest 0..*
• CarePlan 0..*

All resources within the Immunization bundle conform to PIR-defined profiles, which are based on HL7 FHIR R4 (4.0.1). Some resources, such as Consent and CarePlan, may include contained resources. In such cases, the outer resource, along with all contained resources, should be stored as a single resource.

• MessageHeader

  The MessageHeader resource captures key metadata about the immunization bundle, including details about the source and the destination for the message. This resource helps to understand the context of the immunization data exchange and not stored in the Smile CDR.

  MessageHeader	C		MessageHeader	There are no (further) constraints on this element Element id MessageHeader Short description A resource that describes a message that is exchanged between systems Definition The header for a message exchange that is either requesting or responding to an action. The reference(s) that are the subject of the action as well as other information related to the action are typically transmitted in a bundle in which the MessageHeader resource instance is the first resource in the bundle. Data type MessageHeader Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act v2: MSH / MSA / ERR rim: Message
  id	Σ	1..1	id	Element id MessageHeader.id Short description Same unique GUID as resourceBundle.id Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments See Mappings Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a bundleID: (bundle.id)
  meta	Σ	1..1	Meta	There are no (further) constraints on this element Element id MessageHeader.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  id		0..1	string	There are no (further) constraints on this element Element id MessageHeader.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  versionId	Σ	0..1	id	Element id MessageHeader.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments Apply '2025.01.1' (This indicates FHIR changes onJan 2025). Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastUpdated	Σ	0..1	instant	Element id MessageHeader.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments Updated: Relax the previously crossed-out elements. Data type instant Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  source	Σ	0..1	uri	There are no (further) constraints on this element Element id MessageHeader.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  profile	Σ	1..1	canonical(StructureDefinition)Fixed Value	Element id MessageHeader.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments Use 'http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/MessageHeader' Data type canonical(StructureDefinition) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/MessageHeader Mappings rim: n/a
  security	Σ	0..1	CodingBinding	There are no (further) constraints on this element Element id MessageHeader.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  tag	Σ	0..1	Coding	There are no (further) constraints on this element Element id MessageHeader.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id MessageHeader.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..1	codeBinding	There are no (further) constraints on this element Element id MessageHeader.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Binding extensions MaxValueSet AllLanguages Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..1	Narrative	There are no (further) constraints on this element Element id MessageHeader.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		0..1	Resource	There are no (further) constraints on this element Element id MessageHeader.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	?! C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  event[x]	Σ	1..1	Fixed Value	Element id MessageHeader.event[x] Short description Code for the event this message represents or link to event definition Definition Code that identifies the event this message represents and connects it with its definition. Events defined as part of the FHIR specification have the system value "http://terminology.hl7.org/CodeSystem/message-events". Alternatively uri to the EventDefinition. Requirements Drives the behavior associated with this message. Comments Apply 'http://ehealth.bc.ca/panorama/fhir/MessageHeader' Binding One of the message events defined as part of this version of FHIR. MessageEvent (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value http://ehealth.bc.ca/panorama/fhir/MessageHeader Mappings rim: n/a w5: FiveWs.what[x] v2: MSH-9.2 rim: ./payload[classCode="CACT" and moodCode="EVN" and isNormalAct()]/code[isNormalDatatype()]/code
  eventUri			uri	Data type uri
  destination	Σ	1..*	BackboneElement	There are no (further) constraints on this element Element id MessageHeader.destination Short description Message destination application(s) Definition The destination application which the message is intended for. Requirements Indicates where message is to be sent for routing purposes. Allows verification of "am I the intended recipient". Comments There SHOULD be at least one destination, but in some circumstances, the source system is unaware of any particular destination system. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.subject[x] rim: ./communicationFunction[typeCode="RCV"] w5: FiveWs.subject
  id		0..1	string	There are no (further) constraints on this element Element id MessageHeader.destination.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.destination.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.destination.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  name	Σ	1..1	string	Element id MessageHeader.destination.name Short description Name of system Definition Human-readable name for the target system. Requirements May be used for routing of response and/or to support audit. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: MSH-5 rim: unique(./entity[determinerCode="INST" and (classCode=("DEV", "PSN", "ORG"]/name[type='ST' and isNormalDatatype()]) dest-fha: fha dest-HealthGateway: hgwy dest-iha: iha dest-nha: nha dest-vcha: vcha dest-viha: viha dest-indigenousHealthOrganization: indigenous health organizations
  target	Σ C	0..1	Reference(Device)	There are no (further) constraints on this element Element id MessageHeader.destination.target Short description Particular delivery destination within the destination Definition Identifies the target end system in situations where the initial message transmission is to an intermediary system. Requirements Supports multi-hop routing. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Device) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: unique(./entity[determinerCode="INST" and (classCode=("DEV", "PSN", "ORG"]
  id		0..0	string	There are no (further) constraints on this element Element id MessageHeader.destination.target.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.destination.target.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	0..0	string	There are no (further) constraints on this element Element id MessageHeader.destination.target.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  type	Σ	0..0	uriBinding	There are no (further) constraints on this element Element id MessageHeader.destination.target.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..0	Identifier	There are no (further) constraints on this element Element id MessageHeader.destination.target.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..0	string	There are no (further) constraints on this element Element id MessageHeader.destination.target.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  endpoint	Σ	1..1	url	Element id MessageHeader.destination.endpoint Short description Actual destination address or id Definition Indicates where the message should be routed to. Requirements Identifies where to route the message. Comments See Mappings Data type url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: MSH-25 (or MSH-6) rim: ./telecom dest-fha: [id-system-local-base]/ca-bc-fha dest-HealthGateway: [id-system-local-base]/ca-bc-healthGateway dest-iha: [id-system-local-base]/ca-bc-iha dest-nha: [id-system-local-base]/ca-bc-nha dest-OutOfBC: [id-system-local-base]/ca-bc-outofprovince dest-vch: [id-system-local-base]/ca-bc-vcha dest-viha: [id-system-local-base]/ca-bc-viha dest-IndigenousHealthOrganizations: [id-system-local-base]/ca-bc-indigenous health organizations
  receiver	Σ C	0..1	Reference(Organization | Practitioner | PractitionerRole)	There are no (further) constraints on this element Element id MessageHeader.destination.receiver Short description Intended "real-world" recipient for the data Definition Allows data conveyed by a message to be addressed to a particular person or department when routing to a specific application isn't sufficient. Requirements Allows routing beyond just the application level. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Organization | Practitioner | PractitionerRole) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.subject[x] v2: PRT-5:PRT-4='WAYR' / PRT-8:PRT-4='WAYR' rim: Not directly supported. Could be shared using attentionLine.value with an appropriate keyWordText w5: FiveWs.subject
  sender	Σ C	0..1	Reference(Organization | Practitioner | PractitionerRole)	There are no (further) constraints on this element Element id MessageHeader.sender Short description Real world sender of the message Definition Identifies the sending system to allow the use of a trust relationship. Requirements Allows routing beyond just the application level. Comments Use case is for where a (trusted) sending system is responsible for multiple organizations, and therefore cannot differentiate based on source endpoint / authentication alone. Data type Reference(Organization | Practitioner | PractitionerRole) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.subject[x] v2: PRT-5:PRT-4='WAYR' / PRT-8:PRT-4='WAYR' rim: Not directly supported. Could be shared using attentionLine.value with an appropriate keyWordText w5: FiveWs.subject
  enterer	Σ C	0..1	Reference(Practitioner | PractitionerRole)	There are no (further) constraints on this element Element id MessageHeader.enterer Short description The source of the data entry Definition The person or device that performed the data entry leading to this message. When there is more than one candidate, pick the most proximal to the message. Can provide other enterers in extensions. Requirements Need to know for audit/traceback requirements and possibly for authorization. Comments Usually only for the request but can be used in a response. Data type Reference(Practitioner | PractitionerRole) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.author v2: EVN-5 / ORC-10 / PRT-5:PRT-4='EP' / ROL where ROL.3 is EP or ORC.10 rim: unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[typeCode="ENT" and isNormalParticipation]/role[classCode="ASSIGNED" and isNormalRole()]/player[isNormalEntity() and classCode=("DEV", "PSN") and determinerCode="INST"])
  author	Σ C	0..1	Reference(Practitioner | PractitionerRole)	There are no (further) constraints on this element Element id MessageHeader.author Short description The source of the decision Definition The logical author of the message - the person or device that decided the described event should happen. When there is more than one candidate, pick the most proximal to the MessageHeader. Can provide other authors in extensions. Requirements Need to know for audit/traceback requirements and possibly for authorization. Comments Usually only for the request but can be used in a response. Data type Reference(Practitioner | PractitionerRole) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.author v2: ORC-19 / PRT-5:PRT-4='AUT' / ROL where ROL.3 is IP or ORC.12 rim: unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[isHighest(priorityCode) and typeCode="AUT" and isNormalParticipation]/role[classCode="ASSIGNED" and isNormalRole()]/player[isNormalEntity() and classCode=("DEV", "PSN") and determinerCode="INST"])
  source	Σ	1..1	BackboneElement	Element id MessageHeader.source Short description Message source application - PIR Definition The source application from which this message originated - Provincial Immunization Registry (PIR) Requirements Allows replies, supports audit. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.actor rim: unique(./communicationFunction[typeCode="SND"])
  id		0..1	string	There are no (further) constraints on this element Element id MessageHeader.source.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.source.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.source.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  name	Σ	1..1	stringFixed Value	Element id MessageHeader.source.name Short description Name of system Definition Human-readable name for the source system. Requirements May be used to support audit. Comments Hardcode as "PIR Immz" Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value PIR Immz Mappings rim: n/a v2: MSH-3 rim: unique(./entity[determinerCode="INST" and classCode="DEV"]/name[type='ST' and isNormalDatatype()])
  software	Σ	0..1	string	There are no (further) constraints on this element Element id MessageHeader.source.software Short description Name of software running the system Definition May include configuration or other information useful in debugging. Requirements Supports audit and possibly interface engine behavior. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: SFT-3 ( +SFT-1) rim: unique(./entity[determinerCode="INST" and classCode="DEV"]/softwareName[isNormalDatatype()])
  version	Σ	0..1	string	There are no (further) constraints on this element Element id MessageHeader.source.version Short description Version of software running Definition Can convey versions of multiple systems in situations where a message passes through multiple hands. Requirements Supports audit and possibly interface engine behavior. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: SFT-2 rim: (Not supported)
  contact	Σ C	0..1	ContactPoint	There are no (further) constraints on this element Element id MessageHeader.source.contact Short description Human contact for problems Definition An e-mail, phone, website or other contact point to use to resolve issues with message communications. Requirements Allows escalation of technical issues. Data type ContactPoint Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) cpt-2: A system is required if a value is provided. value.empty() or system.exists() Mappings rim: n/a v2: XTN rim: TEL servd: ContactPoint v2: (MSH-22?) rim: unique(./entity[determinerCode="INST" and classCode="DEV"]/scopesRole[normalRole() and classCode="CON" and layer[classCode="PSN"]/telecom[isNormalDatatype()])
  endpoint	Σ	1..1	url	Element id MessageHeader.source.endpoint Short description Actual message source address or id Definition Identifies the routing target to send acknowledgements to. Requirements Identifies where to send responses, may influence security permissions. Comments See Mappings Data type url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: MSH-24 rim: ./telecom[isNormalDatatype()] PIRtest: https://pir.healthbc.org/test/immunization PIRprod: https://pir.healthbc.org/prod/immunization
  responsible	Σ C	1..1	Reference(Organization | Practitioner | PractitionerRole)	Element id MessageHeader.responsible Short description The Panorama Organizational Unit and/or Client Health Region which submitted the message contents. Definition The Panorama Organizational Unit and/or Client Health Region (CHR) that accepts overall responsibility for the contents of the message. The implication is that the message event happened under the policies of the responsible party. Requirements Need to know for audit/traceback requirements and possibly for authorization. Comments See Mappings Data type Reference(Organization | Practitioner | PractitionerRole) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.witness v2: ORC-12 / PRT-5:PRT-4='OP' / PRT-8:PRT-4='OP' / ROL where ROL.3 is RO or ORC.11 rim: unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[isHighest(priorityCode) and typeCode="RESP" and isNormalParticipation]/role[classCode="ASSIGNED" and isNormalRole()]/player[isNormalEntity() and classCode="PSN" and determinerCode="INST"] or ./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[isHighest(priorityCode) and typeCode="RESP" and isNormalParticipation]/role[classCode="ASSIGNED" and isNormalRole()]/scoper[isNormalEntity() and classCode="ORG" and determinerCode="INST"]) source-PIR: CHR or Submitter's Org source-PHSL: clientHealthRegion
  id		0..1	string	There are no (further) constraints on this element Element id MessageHeader.responsible.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.responsible.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	1..1	string	Element id MessageHeader.responsible.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments fullURL of Panorama + 'Organization' + (PIR Org ID). Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id MessageHeader.responsible.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MessageHeader.responsible.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..1	string	There are no (further) constraints on this element Element id MessageHeader.responsible.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  reason	Σ	0..1	CodeableConcept	Element id MessageHeader.reason Short description Cause of event Definition Coded indication of the cause for the event - indicates a reason for the occurrence of the event that is a focus of this message. Requirements Need to be able to track why resources are being changed and report in the audit log/history of the resource. May affect authorization. Comments See Mappings. List of event type(s) in alphabetical which have been triggered, also can be applied for filtering purposes. Data type CodeableConcept Binding Reason for event occurrence. ExampleMessageReasonCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.why[x] v2: EVN.4 / ORC.16 / OBR-31-reason for study / BPO-13-BP indication for use / RXO-20-indication / RXE-27-give indication / RXD-21-indication / RXG-22-indication / RXA-19-indication rim: unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/reasonCode[isNormalDatatype()]) trigger-CHR: CLIENT trriger-humanSubject: CLIENT trigger-riskFactor: RISKFACTOR trigger-subjectName: CLIENT trigger-consent: CONSENT trigger-consentComment: CONSENTCMMT trigger-AEFI: AEFI trigger-aefiRecommendation: AEFI trigger-invalidVaccine: IMMS trigger-deferral: DEFERRAL trigger-forecast: FORECAST trigger-vaccination: IMMS trigger-immsComments-IC: IMMSCMMTIC trigger-immsComments-SC: IMMSCMMTSC trigger-immsComments-DF: IMMSCMMTDF trigger-immsComments-AE: IMMSCMMTAE trigger-specialConsideration: SPECIALCONSID trigger-vaccineStatus: IMMS trigger-clientMerge: CLIENT
  id		0..0	string	There are no (further) constraints on this element Element id MessageHeader.reason.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.reason.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	0..0	Coding	There are no (further) constraints on this element Element id MessageHeader.reason.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  text	Σ	0..1	string	Element id MessageHeader.reason.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments To be applied if IDS message contains only Forecasting data only. See Mappings. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: Forecast
  response	Σ	0..1	BackboneElement	There are no (further) constraints on this element Element id MessageHeader.response Short description If this is a reply to prior message Definition Information about the message that this message is a response to. Only present if this message is a response. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: MSA rim: ./conveyedAcknowledgement
  id		0..1	string	There are no (further) constraints on this element Element id MessageHeader.response.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.response.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.response.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  identifier	Σ	1..1	id	There are no (further) constraints on this element Element id MessageHeader.response.identifier Short description Id of original message Definition The MessageHeader.id of the message to which this message is a response. Requirements Allows receiver to know what message is being responded to. Comments RFC 4122 Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: MSA-2 rim: ./acknowledges.id[isNormalDatatype()]
  code	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id MessageHeader.response.code Short description ok | transient-error | fatal-error Definition Code that identifies the type of response to the message - whether it was successful or not, and whether it should be resent or not. Requirements Allows the sender of the acknowledge message to know if the request was successful or if action is needed. Comments This is a generic response to the request message. Specific data for the response will be found in MessageHeader.focus. Data type code Binding The kind of response to a message. ResponseType (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: MSA-1 rim: ./typeCode[isNormalDatatype()]
  details	Σ C	0..1	Reference(OperationOutcome)	There are no (further) constraints on this element Element id MessageHeader.response.details Short description Specific list of hints/warnings/errors Definition Full details of any issues found in the message. Requirements Allows the sender of the message to determine what the specific issues are. Comments This SHALL be contained in the bundle. If any of the issues are errors, the response code SHALL be an error. Data type Reference(OperationOutcome) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: ERR rim: AcknowledgementDetail or Observation[classCode="ALRT" and moodCode="EVN"]
  focus	Σ C	1..1	Reference(Resource)	Element id MessageHeader.focus Short description The actual content of the message related to a specific patient. Definition The actual data of the message all related to a specific patient. Requirements Every message event is about actual data, a single resource, that is identified in the definition of the event, and perhaps some or all linked resources. Comments The data is defined where the transaction type is defined. The transaction data is always included in the bundle that is the full message. Only the root resource is specified. The resources it references should be contained in the bundle but are not also listed here. Multiple repetitions are allowed to cater for merges and other situations with multiple focal targets. Data type Reference(Resource) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[typeCode="SUBJ" and isNormalParticipation]/role or ./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/outboundRelationship[typeCode="SBJ" and isNormalActRelatoinship]/target)
  id		0..1	string	There are no (further) constraints on this element Element id MessageHeader.focus.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.focus.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	1..1	string	Element id MessageHeader.focus.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments fullURL of Panorama + 'Patient' + PIR Client ID Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id MessageHeader.focus.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MessageHeader.focus.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..1	string	There are no (further) constraints on this element Element id MessageHeader.focus.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  definition	Σ	0..1	canonical(MessageDefinition)	There are no (further) constraints on this element Element id MessageHeader.definition Short description Link to the definition for this message Definition Permanent link to the MessageDefinition for this message. Requirements Allows sender to define the expected contents of the message. Comments see Canonical References Data type canonical(MessageDefinition) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: Not directly supported.

• Patient

  The Patient resource contains demographic information about the individual receiving immunization services. This includes essential details such as name, date of birth, and identifiers. The Patient data is retrieved as part of the immunization bundle and reflects the current status of the patient at the time of immunization.

  Patient_CAbaseline (Patient)	C		Patient	Element id Patient Short description IFHIR resource applies for PIR Client Alternate names SubjectOfCare Client Resident Definition IFHIR resource applies for PIR Client Data type Patient Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act rim: Patient[classCode=PAT] cda: ClinicalDocument.recordTarget.patientRole
  id	Σ	1..1	id	Element id Patient.id Short description PIR Client ID Definition Unique Panorama Client ID Comments See Mappings Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a source-PIR: PIR subject_id
  meta	Σ	1..1	Meta	There are no (further) constraints on this element Element id Patient.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  id		0..1	string	There are no (further) constraints on this element Element id Patient.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  versionId	Σ	0..1	id	Element id Patient.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments Apply '2025.01.1' (This indicates the FHIR Specs changes on 2025 - Jan) Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastUpdated	Σ	0..1	instant	Element id Patient.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments Updated: Relax the previously crossed-out elements. Data type instant Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  source	Σ	0..1	uri	There are no (further) constraints on this element Element id Patient.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  profile	Σ	1..1	canonical(StructureDefinition)	Element id Patient.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments Use 'http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Patient' Data type canonical(StructureDefinition) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  security	Σ	0..1	CodingBinding	There are no (further) constraints on this element Element id Patient.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  tag	Σ	0..1	Coding	There are no (further) constraints on this element Element id Patient.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Patient.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..1	codeBinding	There are no (further) constraints on this element Element id Patient.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Binding extensions MaxValueSet AllLanguages Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..1	Narrative	There are no (further) constraints on this element Element id Patient.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		0..1	Resource	There are no (further) constraints on this element Element id Patient.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
  extension	C	2..*	Extension	There are no (further) constraints on this element Element id Patient.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  genderIdentityExtension	C	0..1	Extension(CodeableConcept)	Element id Patient.extension:genderIdentityExtension Short description The patient's gender identity Alternate names extensions, user content Definition The gender the patient identifies with. The Patient's gender identity is used as guidance (e.g. for staff) about how to interact with the patient. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(CodeableConcept) Extension URL GenderIdentity Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  clientWarningExtension	C	0..*	Extension(Complex)	Element id Patient.extension:clientWarningExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Complex) Extension URL ClientWarningExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  inactiveClientReasonExtension	C	0..1	Extension(CodeableConcept)	Element id Patient.extension:inactiveClientReasonExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments Inactive reason for the client Data type Extension(CodeableConcept) Extension URL InactiveClientReasonExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRIdentifierExtension	C	1..1	Extension(string)	Element id Patient.extension:pIRIdentifierExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(string) Extension URL PIRIdentifierExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRLockSeqNumberExtension	C	1..1	Extension(integer)	Element id Patient.extension:pIRLockSeqNumberExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(integer) Extension URL PIRLockSeqNumberExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	?! C	0..*	Extension	There are no (further) constraints on this element Element id Patient.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  identifier	Σ	1..*	Identifier	Element id Patient.identifier Short description Identifier(s) for this patient Definition Different types of patient identifier which includes JHN (Jurisdictional Health Number e.g. BC PHN), PI (Patient Internal Identifier e.g. PIR Client ID, HAs' Internal Client ID). Requirements Patients are almost always assigned specific numerical identifiers. Comments Extract from PIR <client.human_subject> Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier w5: FiveWs.identifier v2: PID-3 rim: id cda: .id
  id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Role.code or implied by context
  type	Σ	1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments 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. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
  id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier.type.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier.type.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	1..*	Coding	There are no (further) constraints on this element Element id Patient.identifier.type.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier.type.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier.type.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	0..1	uriFixed Value	Element id Patient.identifier.type.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments http://terminology.hl7.org/CodeSystem/v2-0203 Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value http://terminology.hl7.org/CodeSystem/v2-0203 Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  version	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.identifier.type.coding.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	0..1	code	Element id Patient.identifier.type.coding.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments See Mappings Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code JHN: JHN JPID: JPID MR: MR PI: PI
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.identifier.type.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Patient.identifier.type.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	Element id Patient.identifier.type.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: Panorama Client ID source-FHA: FHA-PARIS Client ID source-NHA-CeDaR: NHA- CeDaR ID source-NHA-MOIS: NHA - MOIS ID source-VCH: VCH-PARIS Client ID source-ProfileEMR: ProfileEMR_ClientID source-CAN-ArmedForces: Canadian Armed Forces IDentification Number source-CAN-RCMP: Canadian RCMP Regiment Number source-CAN-VeteranAffairs: Veteran Affairs CAnadian Identification Number
  system	Σ	1..1	uri	Element id Patient.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments See Mappings below for appropriate URLs and URNs. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType JHN-BC: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-patient-healthcare-id PI-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-client-id JHN-YT: https://fhir.infoway-inforoute.ca/NamingSystem/ca-yt-patient-healthcare-id PI-FHA: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-fha-patient-id PI-NHA: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-nha-patient-id PI-VCH: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-vcha-patient-id PI-CAN-ArmedForces: urn: 2.16.840.1.113883.3.51.1.1.6.15 PI-RCMP: urn:2.16.840.1.113883.3.51.1.1.6.16 PI-CAN-VeteranAffairs: urn:2.16.840.1.113883.3.51.1.1.6.18 PI-ProfileEMR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-profile-emr-patient-id
  value	Σ	1..1	string	Element id Patient.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments PIR Client ID: Extract from PIR (client.human_subject.subject_id); BC PHN or Yukon PHN: Extract from PIR (client.human_subject.health_card_number) Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 123456 Mappings rim: n/a v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value JHN-BC: Extract from PIR (client.human_subject.health_card_number) JHN-YT: Extract from PIR (client.human_subject.health_card_number) PI-PIR: Extract from PIR (client.human_subject.subject_id) PI-FHA: FHA-PARIS Client ID PI-NHA: NHA- CeDaR ID PI-VCH: VCH-PARIS Client ID
  period	Σ C	0..1	Period	There are no (further) constraints on this element Element id Patient.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
  assigner	Σ C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments 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. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
  active	Σ ?!	1..1	boolean	Element id Patient.active Short description Whether this patient's record is in active use in PIR. Definition It is used to filter patient lists to exclude inactive patients Inactive patient lists include inactive reasons in (Created in Error, Retruned to Birth Parent, Adopted, Soft Deleted, Deceased). Requirements Need to be able to mark a patient record as not to be used because it was created in error. Comments Hardcode as 'True' for all PIR active clients. Meaning when missing This resource is generally assumed to be active if no value is provided for the active element Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.status rim: statusCode cda: n/a
  name	Σ	1..*	HumanName	Element id Patient.name Short description A name associated with the patient Definition PIR Client Lastname, Firstname, Middlename Requirements Need to be able to track the patient by multiple names. Examples are your official name and a partner name. Comments Extract from PIR <client.human_subject> Data type HumanName Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN rim: EN (actually, PN) servd: ProviderName v2: PID-5, PID-9 rim: name cda: .patient.name
  id		0..1	string	There are no (further) constraints on this element Element id Patient.name.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.name.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  use	Σ ?!	0..1	codeBinding	Element id Patient.name.use Short description usual | official | temp | nickname | anonymous | old | maiden Definition Identifies the purpose for this name. Requirements Allows the appropriate name for a particular context of use to be selected from among a set of names. Comments See Mappings Data type code Binding The use of a human name. NameUse (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN.7, but often indicated by which field contains the name rim: unique(./use) servd: ./NamePurpose legal: official alias: usual
  text	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.name.text Short description Text representation of the full name Definition Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts. Requirements A renderable, unencoded form. Comments Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: implied by XPN.11 rim: ./formatted
  family	Σ	1..1	string	Element id Patient.name.family Short description Patient Family Name Alternate names surname Definition Patient Family Name Comments Patient Family Name Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN.1/FN.1 rim: ./part[partType = FAM] servd: ./FamilyName
  given	Σ	1..*	string	Element id Patient.name.given Short description Patient Given Names Alternate names first name, middle name Definition Patient Given Names Comments Patient Given Names Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN.2 + XPN.3 rim: ./part[partType = GIV] servd: ./GivenNames
  prefix	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.name.prefix Short description Parts that come before the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN.5 rim: ./part[partType = PFX] servd: ./TitleCode
  suffix	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.name.suffix Short description Parts that come after the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN/4 rim: ./part[partType = SFX]
  period	Σ C	0..1	Period	There are no (further) constraints on this element Element id Patient.name.period Short description Time period when name was/is in use Definition Indicates the period of time when this name was valid for the named person. Requirements Allows names to be placed in historical context. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: XPN.13 + XPN.14 rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
  telecom	Σ C	0..*	ContactPoint	Element id Patient.telecom Short description A contact detail for the PIR Client Definition A contact detail (e.g. a telephone number or an email address) by which the PIR client may be contacted. Requirements People have (primary) ways to contact them in some way such as phone, email. Comments A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone). Data type ContactPoint Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) cpt-2: A system is required if a value is provided. value.empty() or system.exists() Mappings rim: n/a v2: XTN rim: TEL servd: ContactPoint v2: PID-13, PID-14, PID-40 rim: telecom cda: .telecom
  id		0..0	string	There are no (further) constraints on this element Element id Patient.telecom.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.telecom.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ C	0..1	codeBinding	Element id Patient.telecom.system Short description phone | fax | email | pager | url | sms | other Definition Telecommunications form for contact point - what communications system is required to make use of the contact. Comments Use 'phone | email'. Extract the current phone or email from PIR, not the ones with 'Effective Date To' populated. Data type code Binding Telecommunications form for contact point. ContactPointSystem (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1, cpt-2 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XTN.3 rim: ./scheme servd: ./ContactPointType
  value	Σ	0..1	string	Element id Patient.telecom.value Short description Patient Phone Number or Email Definition Patient Phone Number or Email Requirements Need to support legacy numbers that are not in a tightly controlled format. Comments Patient Phone Number | Email Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XTN.1 (or XTN.12) rim: ./url servd: ./Value
  use	Σ ?!	0..1	codeBinding	Element id Patient.telecom.use Short description home | work | mobile - purpose of this contact point Definition Identifies the purpose for the contact point. Requirements Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. Comments Use "home" | "work" |"mobile" (See Mappings). If not listed in the mappings, drop the attirubte USE, do not send. Data type code Binding Use of contact point. ContactPointUse (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XTN.2 - but often indicated by field rim: unique(./use) servd: ./ContactPointPurpose pirHOME: home pirBUSINESS: work pirMOBILE: mobile
  rank	Σ	0..0	positiveInt	There are no (further) constraints on this element Element id Patient.telecom.rank Short description Specify preferred order of use (1 = highest) Definition Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values. Comments Note that rank does not necessarily follow the order in which the contacts are represented in the instance. Data type positiveInt Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: n/a
  period	Σ C	0..1	Period	There are no (further) constraints on this element Element id Patient.telecom.period Short description Time period when the contact point was/is in use Definition Time period when the contact point was/is in use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: N/A rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
  id		0..0	string	There are no (further) constraints on this element Element id Patient.telecom.period.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.telecom.period.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  start	Σ C	0..1	dateTime	There are no (further) constraints on this element Element id Patient.telecom.period.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments If the low element is missing, the meaning is that the low boundary is not known. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1, per-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: DR.1 rim: ./low
  end	Σ C	0..1	dateTime	There are no (further) constraints on this element Element id Patient.telecom.period.end Short description End time with inclusive boundary, if not ongoing Definition The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. Meaning when missing If the end of the period is missing, it means that the period is ongoing Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1, per-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: DR.2 rim: ./high
  gender	Σ	1..1	codeBinding	Element id Patient.gender Short description male | female | other | unknown Definition Patient Administrative Gender. PIR gender "Undifferentiate" is mapped to "unknown" in FHIR. Requirements Needed for identification of the individual, in combination with (at least) name and birth date. Comments Patient Administrative Gender Data type code Binding The gender of a person used for administrative purposes. AdministrativeGender (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: PID-8 rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender cda: .patient.administrativeGenderCode
  id		0..0	string	There are no (further) constraints on this element Element id Patient.gender.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.gender.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  value		0..1	System.String	There are no (further) constraints on this element Element id Patient.gender.value Short description Primitive value for code Definition Primitive value for code Data type System.String Maximum string length 1048576
  birthDate	Σ	1..1	date	Element id Patient.birthDate Short description Patient Date of Birth Definition Patient Date of Birth Requirements Age of the individual drives many clinical processes. Comments Patient Date of Birth (yyyy-mm-dd) Data type date Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: PID-7 rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime cda: .patient.birthTime loinc: 21112-8
  deceased[x]	Σ ?!	0..1		There are no (further) constraints on this element Element id Patient.deceased[x] Short description Indicates if the individual is deceased or not Definition Indicates if the individual is deceased or not. Requirements The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. Comments If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: PID-30 (bool) and PID-29 (datetime) rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime cda: n/a
  deceasedBoolean			boolean	There are no (further) constraints on this element Data type boolean
  deceasedDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
  address	Σ	0..2	Address	Element id Patient.address Short description An address for the individual Definition An address for the individual. Requirements May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Comments If a HOME address exists in PIR, it will always be sent. If the Effective From of Postal Address > Effective From of Home Address, it will also be sent Data type Address Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XAD rim: AD servd: Address v2: PID-11 rim: addr cda: .addr
  id		0..1	string	There are no (further) constraints on this element Element id Patient.address.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.address.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  use	Σ ?!	0..1	codeBinding	Element id Patient.address.use Short description home | work | temp | old | billing - purpose of this address Definition The purpose of this address: home | work Requirements Allows an appropriate address to be chosen from a list of many. Comments See Mappings Data type code Binding The use of an address. AddressUse (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General home Mappings rim: n/a v2: XAD.7 rim: unique(./use) servd: ./AddressPurpose pir-PrimaryHome: home
  type	Σ	0..1	codeBinding	Element id Patient.address.type Short description postal | physical | both Definition Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both. Comments See Mappings. Data type code Binding The type of an address (physical / postal). AddressType (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General both Mappings rim: n/a v2: XAD.18 rim: unique(./use) vcard: address type parameter pir-PostalAddress: postal
  text	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.text Short description Text representation of the address Definition Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts. Requirements A renderable, unencoded form. Comments Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 137 Nowhere Street, Erewhon 9132 Mappings rim: n/a v2: XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6 rim: ./formatted vcard: address label parameter
  line	Σ	0..*	string	Element id Patient.address.line Short description Street name, number, direction & P.O. Box etc. Definition This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. Comments Use address.line for international address Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 137 Nowhere Street Mappings rim: n/a v2: XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address) rim: AD.part[parttype = AL] vcard: street servd: ./StreetAddress (newline delimitted)
  id		0..1	string	There are no (further) constraints on this element Element id Patient.address.line.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.address.line.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  _line	C	0..1	Extension(string)	Element id Patient.address.line.extension:_line Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments See Mappings Data type Extension(string) Extension URL AddressLineExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A houseNumber: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber streetName: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName streetNameType: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetNameType direction: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-direction unitID: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID
  value		0..1	System.String	There are no (further) constraints on this element Element id Patient.address.line.value Short description Primitive value for string Definition Primitive value for string Data type System.String Maximum string length 1048576
  city	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.city Short description Name of city, town etc. Alternate names Municpality Definition The name of the city, town, suburb, village or other community or delivery center. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General Erewhon Mappings rim: n/a v2: XAD.3 rim: AD.part[parttype = CTY] vcard: locality servd: ./Jurisdiction
  district	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.district Short description District name (aka county) Alternate names County Definition The name of the administrative area (county). Comments District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General Madison Mappings rim: n/a v2: XAD.9 rim: AD.part[parttype = CNT | CPA]
  state	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.state Short description Sub-unit of country (abbreviations ok) Alternate names Province, Territory Definition Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes). Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XAD.4 rim: AD.part[parttype = STA] vcard: region servd: ./Region
  postalCode	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.postalCode Short description Postal code for area Alternate names Zip Definition A postal code designating a region defined by the postal service. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 9132 Mappings rim: n/a v2: XAD.5 rim: AD.part[parttype = ZIP] vcard: code servd: ./PostalIdentificationCode
  country	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.country Short description Country (e.g. can be ISO 3166 2 or 3 letter code) Definition Country - a nation as commonly understood or generally accepted. Comments ISO 3166 3 letter codes can be used in place of a human readable country name. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XAD.6 rim: AD.part[parttype = CNT] vcard: country servd: ./Country
  period	Σ C	0..1	Period	There are no (further) constraints on this element Element id Patient.address.period Short description Time period when address was/is in use Definition Time period when address was/is in use. Requirements Allows addresses to be placed in historical context. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Examples General { "start": "2010-03-23", "end": "2010-07-01" } Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: XAD.12 / XAD.13 + XAD.14 rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
  maritalStatus		0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.maritalStatus Short description Marital (civil) status of a patient Definition This field contains a patient's most recent marital (civil) status. Requirements Most, if not all systems capture it. Comments 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. Data type CodeableConcept Binding The domestic partnership status of a person. Marital Status Codes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: PID-16 rim: player[classCode=PSN]/maritalStatusCode cda: .patient.maritalStatusCode
  multipleBirth[x]		0..1		There are no (further) constraints on this element Element id Patient.multipleBirth[x] Short description Whether patient is part of a multiple birth Definition Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). Requirements For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. Comments Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: PID-24 (bool), PID-25 (integer) rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber cda: n/a
  multipleBirthBoolean			boolean	There are no (further) constraints on this element Data type boolean
  multipleBirthInteger			integer	There are no (further) constraints on this element Data type integer
  photo	C	0..1	Attachment	There are no (further) constraints on this element Element id Patient.photo Short description Image of the patient Definition Image of the patient. Requirements Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Comments Guidelines: Use id photos, not clinical photos. Limit dimensions to thumbnail. Keep byte count low to ease resource updates. Data type Attachment Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) att-1: If the Attachment has data, it SHALL have a contentType data.empty() or contentType.exists() Mappings rim: n/a v2: ED/RP rim: ED v2: OBX-5 - needs a profile rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc cda: n/a
  contact	C	0..1	BackboneElement	There are no (further) constraints on this element Element id Patient.contact Short description A contact party (e.g. guardian, partner, friend) for the patient Definition A contact party (e.g. guardian, partner, friend) for the patient. Requirements Need to track people you can contact about the patient. Comments Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) pat-1: SHALL at least contain a contact's details or a reference to an organization name.exists() or telecom.exists() or address.exists() or organization.exists() Mappings rim: n/a rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON] cda: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Patient.contact.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.contact.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Patient.contact.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  relationship		0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.contact.relationship Short description The kind of relationship Definition The nature of the relationship between the patient and the contact person. Requirements Used to determine which contact person is the most relevant to approach, depending on circumstances. Comments 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. Data type CodeableConcept Binding The nature of the relationship between a patient and a contact person for that patient. PatientContactRelationship (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: NK1-7, NK1-3 rim: code cda: n/a
  name		0..1	HumanName	There are no (further) constraints on this element Element id Patient.contact.name Short description A name associated with the contact person Definition A name associated with the contact person. Requirements Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. Comments Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely. Data type HumanName Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN rim: EN (actually, PN) servd: ProviderName v2: NK1-2 rim: name cda: n/a
  telecom	C	0..*	ContactPoint	There are no (further) constraints on this element Element id Patient.contact.telecom Short description A contact detail for the person Definition A contact detail for the person, e.g. a telephone number or an email address. Requirements People have (primary) ways to contact them in some way such as phone, email. Comments Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification. Data type ContactPoint Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) cpt-2: A system is required if a value is provided. value.empty() or system.exists() Mappings rim: n/a v2: XTN rim: TEL servd: ContactPoint v2: NK1-5, NK1-6, NK1-40 rim: telecom cda: n/a
  address		0..1	Address	There are no (further) constraints on this element Element id Patient.contact.address Short description Address for the contact person Definition Address for the contact person. Requirements Need to keep track where the contact person can be contacted per postal mail or visited. Comments Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource). Data type Address Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XAD rim: AD servd: Address v2: NK1-4 rim: addr cda: n/a
  gender		0..1	codeBinding	There are no (further) constraints on this element Element id Patient.contact.gender Short description male | female | other | unknown Definition Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Requirements Needed to address the person correctly. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding The gender of a person used for administrative purposes. AdministrativeGender (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: NK1-15 rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender cda: n/a
  organization	C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.contact.organization Short description Organization that is associated with the contact Definition Organization on behalf of which the contact is acting or for which the contact is working. Requirements For guardians or business related contacts, the organization is relevant. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1, pat-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: NK1-13, NK1-30, NK1-31, NK1-32, NK1-41 rim: scoper cda: n/a
  period	C	0..1	Period	There are no (further) constraints on this element Element id Patient.contact.period Short description The period during which this contact person or organization is valid to be contacted relating to this patient Definition The period during which this contact person or organization is valid to be contacted relating to this patient. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] rim: effectiveTime cda: n/a
  communication		0..1	BackboneElement	There are no (further) constraints on this element Element id Patient.communication Short description A language which may be used to communicate with the patient about his or her health Definition A language which may be used to communicate with the patient about his or her health. Requirements If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest. Comments If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: LanguageCommunication cda: patient.languageCommunication
  id		0..1	string	There are no (further) constraints on this element Element id Patient.communication.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  language		1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.communication.language Short description The language which can be used to communicate with the patient about his or her health Definition The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English. Requirements Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. Comments The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. Data type CodeableConcept Binding A human language. CommonLanguages (preferred) Binding extensions MaxValueSet AllLanguages Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: PID-15, LAN-2 rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code cda: .languageCode
  preferred		0..1	boolean	There are no (further) constraints on this element Element id Patient.communication.preferred Short description Language preference indicator Definition Indicates whether or not the patient prefers this language (over other languages he masters up a certain level). Requirements People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. Comments This language is specifically identified for communicating healthcare information. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: PID-15 rim: preferenceInd cda: .preferenceInd
  generalPractitioner	C	0..1	Reference(Organization | Practitioner | PractitionerRole)	There are no (further) constraints on this element Element id Patient.generalPractitioner Short description Patient's nominated primary care provider Alternate names careProvider Definition Patient's nominated care provider. Comments This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. Data type Reference(Organization | Practitioner | PractitionerRole) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: PD1-4 rim: subjectOf.CareEvent.performer.AssignedEntity cda: n/a
  managingOrganization	Σ C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.managingOrganization Short description Organization that is the custodian of the patient record Definition Organization that is the custodian of the patient record. Requirements Need to know who recognizes this patient record, manages and updates it. Comments There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: scoper cda: .providerOrganization
  link	Σ ?!	0..1	BackboneElement	There are no (further) constraints on this element Element id Patient.link Short description Link to another patient resource that concerns the same actual person Definition Link to another patient resource that concerns the same actual patient. Requirements There are multiple use cases: Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and Distribution of patient information across multiple servers. Comments There is no assumption that linked patient records have mutual links. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: outboundLink cda: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Patient.link.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.link.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Patient.link.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  other	Σ C	1..1	Reference(Patient | RelatedPerson)	There are no (further) constraints on this element Element id Patient.link.other Short description The other patient or related person resource that the link refers to Definition The other patient resource that the link refers to. Comments Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Data type Reference(Patient | RelatedPerson) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: PID-3, MRG-1 rim: id cda: n/a
  id		0..0	string	There are no (further) constraints on this element Element id Patient.link.other.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Patient.link.other.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	1..1	string	Element id Patient.link.other.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A resrouceType-PIRID: fullURL of Panorama + 'Patient' + <PIR Client ID>
  type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id Patient.link.other.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Patient.link.other.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.link.other.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  type	Σ	1..1	codeBinding	Element id Patient.link.type Short description replaced-by | replaces | refer | seealso Definition Use 'replaces' for resourcePatient as the survivor patient out of a merge. Comments "replaces" non-survivor patient id with survivor patient id. Data type code Binding The type of link between this patient resource and another patient resource. LinkType (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: typeCode cda: n/a

• Organization

  The Organization resource represents the health facility or institution associated with the immunization data. This resource is crucial for identifying which organization is responsible for providing immunization services and managing the immunization data.

  OrganizationPIR (Organization)	C		Organization	Element id Organization Short description FHIR resource applies for PIR/Panorama as root organization Definition FHIR resource applies for PIR/Panorama as root organization Data type Organization Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() org-1: The organization SHALL at least have a name or an identifier, and possibly more than one (identifier.count() + name.count()) > 0 Mappings rim: Entity. Role, or Act v2: (also see master files messages) rim: Organization(classCode=ORG, determinerCode=INST) servd: Organization
  id	Σ	1..1	id	Element id Organization.id Short description PIR Organizational ID of Panorama as the root. Definition PIR Organizational ID of Panorama as the root. Comments See Mappings Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a Org-PIR: "1"
  meta	Σ	1..1	Meta	There are no (further) constraints on this element Element id Organization.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  id		0..1	string	There are no (further) constraints on this element Element id Organization.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Organization.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  versionId	Σ	0..1	id	Element id Organization.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments Apply '2025.01' (This indicates FHIR changes on 2025-Jan) Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastUpdated	Σ	0..1	instant	Element id Organization.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments Updated: 1. meta attributes Data type instant Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  source	Σ	0..1	uri	There are no (further) constraints on this element Element id Organization.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  profile	Σ	1..1	canonical(StructureDefinition)	Element id Organization.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments Apply "http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/OrganizationPIR" Data type canonical(StructureDefinition) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  security	Σ	0..0	CodingBinding	There are no (further) constraints on this element Element id Organization.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  tag	Σ	0..0	Coding	There are no (further) constraints on this element Element id Organization.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  implicitRules	Σ ?!	0..0	uri	There are no (further) constraints on this element Element id Organization.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..0	codeBinding	There are no (further) constraints on this element Element id Organization.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Binding extensions MaxValueSet AllLanguages Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..0	Narrative	There are no (further) constraints on this element Element id Organization.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		0..0	Resource	There are no (further) constraints on this element Element id Organization.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Organization.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	?! C	0..*	Extension	There are no (further) constraints on this element Element id Organization.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  identifier	Σ C	1..1	Identifier	Element id Organization.identifier Short description PIR Organizational ID of Panorama as the root. Definition PIR Organizational ID of Panorama as the root. Requirements Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1, org-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier w5: FiveWs.identifier v2: XON.10 / XON.3 rim: .scopes[Role](classCode=IDENT) servd: ./Identifiers
  id		0..0	string	There are no (further) constraints on this element Element id Organization.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Organization.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  use	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id Organization.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Role.code or implied by context
  type	Σ	0..0	CodeableConceptBinding	There are no (further) constraints on this element Element id Organization.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments 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. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
  system	Σ	1..1	uri	Element id Organization.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments Use 'https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-organization-unit-id' Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
  value	Σ	1..1	string	Element id Organization.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments Apply "1" to indicate Panorama. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 123456 Mappings rim: n/a v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
  period	Σ C	0..0	Period	There are no (further) constraints on this element Element id Organization.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
  assigner	Σ C	0..0	Reference(Organization)	There are no (further) constraints on this element Element id Organization.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments 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. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
  active	Σ ?!	0..0	boolean	There are no (further) constraints on this element Element id Organization.active Short description Whether the organization's record is still in active use Definition Whether the organization's record is still in active use. Requirements Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI. Comments This active flag is not intended to be used to mark an organization as temporarily closed or under construction. Instead the Location(s) within the Organization should have the suspended status. If further details of the reason for the suspension are required, then an extension on this element should be used. This element is labeled as a modifier because it may be used to mark that the resource was created in error. Meaning when missing This resource is generally assumed to be active if no value is provided for the active element Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.status v2: No equivalent in HL7 v2 rim: .status servd: ./Status (however this concept in ServD more covers why the organization is active or not, could be delisted, deregistered, not operational yet) this could alternatively be derived from ./StartDate and ./EndDate and given a context date.
  type	Σ	0..0	CodeableConcept	There are no (further) constraints on this element Element id Organization.type Short description Kind of organization Definition The kind(s) of organization that this is. Requirements Need to be able to track the kind of organization that this is - different organization types have different uses. Comments Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes When considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center. We expect that some jurisdictions will profile this optionality to be a single cardinality. Data type CodeableConcept Binding Used to categorize the organization. OrganizationType (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.class v2: No equivalent in v2 rim: .code servd: n/a
  name	Σ C	1..1	string	Element id Organization.name Short description Name used for the organization - Panorama Definition A name associated with the organization - Panorama Requirements Need to use the name as the label of the organization. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, org-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XON.1 rim: .name servd: .PreferredName/Name source-PIR: ploephs.organization_unit.name
  alias		0..0	string	There are no (further) constraints on this element Element id Organization.alias Short description A list of alternate names that the organization is known as, or was known as in the past Definition A list of alternate names that the organization is known as, or was known as in the past. Requirements Over time locations and organizations go through many changes and can be known by different names. For searching knowing previous names that the organization was known by can be very useful. Comments There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the organization. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .name
  telecom	C	0..0	ContactPoint	There are no (further) constraints on this element Element id Organization.telecom Short description A contact detail for the organization Definition A contact detail for the organization. Requirements Human contact for the organization. Comments The use code 'home' is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself. Data type ContactPoint Conditions The cardinality or value of this element may be affected by these constraints: ele-1, org-3 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) cpt-2: A system is required if a value is provided. value.empty() or system.exists() org-3: The telecom of an organization can never be of use 'home' where(use = 'home').empty() Mappings rim: n/a v2: XTN rim: TEL servd: ContactPoint v2: ORC-22? rim: .telecom servd: ./ContactPoints
  address	C	0..0	Address	There are no (further) constraints on this element Element id Organization.address Short description An address for the organization Definition An address for the organization. Requirements May need to keep track of the organization's addresses for contacting, billing or reporting requirements. Comments Organization may have multiple addresses with different uses or applicable periods. The use code 'home' is not to be used. Data type Address Conditions The cardinality or value of this element may be affected by these constraints: ele-1, org-2 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) org-2: An address of an organization can never be of use 'home' where(use = 'home').empty() Mappings rim: n/a v2: XAD rim: AD servd: Address v2: ORC-23? rim: .address servd: ./PrimaryAddress and ./OtherAddresses
  partOf	Σ C	0..0	Reference(Organization)	There are no (further) constraints on this element Element id Organization.partOf Short description The organization of which this organization forms a part Definition The organization of which this organization forms a part. Requirements Need to be able to track the hierarchy of organizations within an organization. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: No equivalent in HL7 v2 rim: .playedBy[classCode=Part].scoper servd: n/a
  contact		0..0	BackboneElement	There are no (further) constraints on this element Element id Organization.contact Short description Contact for the organization for a certain purpose Definition Contact for the organization for a certain purpose. Requirements Need to keep track of assigned contact points within bigger organization. Comments Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .contactParty
  endpoint	C	0..0	Reference(Endpoint)	There are no (further) constraints on this element Element id Organization.endpoint Short description Technical endpoints providing access to services operated for the organization Definition Technical endpoints providing access to services operated for the organization. Requirements Organizations have multiple systems that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Endpoint) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

• Location

  The Location resource identifies the physical site where immunizations were administered. This resource helps to associate the immunization event with a specific place, which is essential for tracking the location of immunization delivery.

  Location	C		Location	Element id Location Short description FHIR resource applies for PIR Vaccine Administered SDL Definition FHIR resource applies for PIR Vaccine Administered Service Delivery Location (SDL) Data type Location Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act rim: .Role[classCode=SDLC]
  id	Σ	1..1	id	Element id Location.id Short description PIR internal SDL ID + PIR internal Immz Org Definition PIR internal Service Delivery Location (SDL) Identifier + PIR internal Immunization Organization (Immz Org) Identifier. SDL refers to the site where vaccine is being administered. Comments See Mappings Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a source-PIR: (PIR Location Id) + 'org' + (PIR Imms Org ID) source-PIR-Unknown: (UNK) + 'org' + (PIR Imms Org ID)
  meta	Σ	1..1	Meta	There are no (further) constraints on this element Element id Location.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  id		0..1	string	There are no (further) constraints on this element Element id Location.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Location.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  versionId	Σ	0..1	id	Element id Location.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments Use '2025.01.1' (This indicates FHIR changes on 2025-Jan). Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastUpdated	Σ	0..1	instant	Element id Location.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments Updated: 1. Relax the previously crossed-out elements. 2 For element ID and IDENTIFIER, remove the counter when value = UNK. It used to be UNK1, or UNK2 or UNK3 etc., this counter is no longer needed as the associated Imms Org is now concatenated to the LOC ID (e.g. UNKorg81). Data type instant Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  source	Σ	0..1	uri	There are no (further) constraints on this element Element id Location.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  profile	Σ	1..1	canonical(StructureDefinition)	Element id Location.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments Use 'http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Location' Data type canonical(StructureDefinition) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  security	Σ	0..1	CodingBinding	There are no (further) constraints on this element Element id Location.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  tag	Σ	0..1	Coding	There are no (further) constraints on this element Element id Location.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Location.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..1	codeBinding	There are no (further) constraints on this element Element id Location.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Binding extensions MaxValueSet AllLanguages Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..1	Narrative	There are no (further) constraints on this element Element id Location.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		0..1	Resource	There are no (further) constraints on this element Element id Location.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Location.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	?! C	0..*	Extension	There are no (further) constraints on this element Element id Location.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  identifier	Σ	1..1	Identifier	Element id Location.identifier Short description PIR internal SDL ID Definition PIR internal Service Delivery Location (SDL) Identifier. SDL refers to the site where vaccine is being administered. Requirements Organization label locations in registries, need to keep track of those. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier w5: FiveWs.identifier rim: .id
  id		0..1	string	There are no (further) constraints on this element Element id Location.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Location.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Location.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Role.code or implied by context
  type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Location.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments 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. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
  system	Σ	1..1	uri	Element id Location.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType source-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-service-delivery-location-id
  value	Σ	1..1	string	Element id Location.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 123456 Mappings rim: n/a v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value source-PIR-Unknown: (UNK) + 'org' + (PIR Imms Org ID) source-PIR-known: Extract from (imms.h33_vaccination_master.location_id)
  period	Σ C	0..1	Period	There are no (further) constraints on this element Element id Location.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
  assigner	Σ C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Location.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments 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. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
  status	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Location.status Short description active | suspended | inactive Definition The status property covers the general availability of the resource, not the current value which may be covered by the operationStatus, or by a schedule/slots if they are configured for the location. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding Indicates whether the location is still in use. LocationStatus (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.status rim: .statusCode
  operationalStatus	Σ	0..1	CodingBinding	There are no (further) constraints on this element Element id Location.operationalStatus Short description The operational status of the location (typically only for a bed/room) Definition The operational status covers operation values most relevant to beds (but can also apply to rooms/units/chairs/etc. such as an isolation unit/dialysis chair). This typically covers concepts such as contamination, housekeeping, and other activities like maintenance. Comments 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. Data type Coding Binding The operational status if the location (where typically a bed/room). v2.0116 (preferred) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding w5: FiveWs.status
  name	Σ	0..1	string	Element id Location.name Short description Name of the SDL Definition Name of the Service Delivery Location where vaccine is being administered. Comments SDL - Derive name from location name (imms.h33_vaccination_master.location_id) Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .name
  alias		0..1	string	There are no (further) constraints on this element Element id Location.alias Short description A list of alternate names that the location is known as, or was known as, in the past Definition A list of alternate names that the location is known as, or was known as, in the past. Requirements Over time locations and organizations go through many changes and can be known by different names. For searching knowing previous names that the location was known by can be very useful. Comments There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the location. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .name
  description	Σ	0..1	string	There are no (further) constraints on this element Element id Location.description Short description Additional details about the location that could be displayed as further information to identify the location beyond its name Definition Description of the Location, which helps in finding or referencing the place. Requirements Humans need additional information to verify a correct location has been identified. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .playingEntity[classCode=PLC determinerCode=INSTANCE].desc
  mode	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Location.mode Short description instance | kind Definition Indicates whether a resource instance represents a specific location or a class of locations. Requirements When using a Location resource for scheduling or orders, we need to be able to refer to a class of Locations instead of a specific Location. Comments This is labeled as a modifier because whether or not the location is a class of locations changes how it can be used and understood. Data type code Binding Indicates whether a resource instance represents a specific location or a class of locations. LocationMode (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.class rim: .playingEntity[classCode=PLC].determinerCode
  type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Location.type Short description Type of function performed Definition Indicates the type of function performed at the location. Comments 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. Data type CodeableConcept Binding Indicates the type of function performed at the location. v3.ServiceDeliveryLocationRoleType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.class rim: .code
  telecom	C	0..1	ContactPoint	There are no (further) constraints on this element Element id Location.telecom Short description Contact details of the location Definition The contact details of communication devices available at the location. This can include phone numbers, fax numbers, mobile numbers, email addresses and web sites. Data type ContactPoint Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) cpt-2: A system is required if a value is provided. value.empty() or system.exists() Mappings rim: n/a v2: XTN rim: TEL servd: ContactPoint rim: .telecom
  address		0..1	Address	There are no (further) constraints on this element Element id Location.address Short description Physical location Definition Physical location. Requirements If locations can be visited, we need to keep track of their address. Comments Additional addresses should be recorded using another instance of the Location resource, or via the Organization. Data type Address Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XAD rim: AD servd: Address rim: .addr
  physicalType	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id Location.physicalType Short description Physical form of the location Definition Physical form of the location, e.g. building, room, vehicle, road. Requirements For purposes of showing relevant locations in queries, we need to categorize locations. Comments 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. Data type CodeableConcept Binding Physical form of the location. LocationType (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.class rim: .playingEntity [classCode=PLC].code
  position		0..1	BackboneElement	There are no (further) constraints on this element Element id Location.position Short description The absolute geographic location Definition The absolute geographic location of the Location, expressed using the WGS84 datum (This is the same co-ordinate system used in KML). Requirements For mobile applications and automated route-finding knowing the exact location of the Location is required. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .playingEntity [classCode=PLC determinerCode=INSTANCE].positionText
  id		0..1	string	There are no (further) constraints on this element Element id Location.position.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Location.position.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Location.position.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  longitude		1..1	decimal	There are no (further) constraints on this element Element id Location.position.longitude Short description Longitude with WGS84 datum Definition Longitude. The value domain and the interpretation are the same as for the text of the longitude element in KML (see notes below). Comments Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger) Data type decimal Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: (RIM Opted not to map the sub-elements of GPS location, is now an OBS)
  latitude		1..1	decimal	There are no (further) constraints on this element Element id Location.position.latitude Short description Latitude with WGS84 datum Definition Latitude. The value domain and the interpretation are the same as for the text of the latitude element in KML (see notes below). Comments Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger) Data type decimal Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: (RIM Opted not to map the sub-elements of GPS location, is now an OBS)
  altitude		0..1	decimal	There are no (further) constraints on this element Element id Location.position.altitude Short description Altitude with WGS84 datum Definition Altitude. The value domain and the interpretation are the same as for the text of the altitude element in KML (see notes below). Comments Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger) Data type decimal Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: (RIM Opted not to map the sub-elements of GPS location, is now an OBS)
  managingOrganization	Σ C	1..1	Reference(Organization)	Element id Location.managingOrganization Short description Immunization Organization responsible for the SDL Definition The immunization organization responsible for the provisioning and upkeep of the service delivery location. Requirements Need to know who manages the location. Comments This can also be used as the part of the organization hierarchy where this location provides services. These services can be defined through the HealthcareService resource. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .scopingEntity[classCode=ORG determinerKind=INSTANCE]
  id		0..1	string	There are no (further) constraints on this element Element id Location.managingOrganization.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Location.managingOrganization.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	1..1	string	Element id Location.managingOrganization.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments fullURL of Panorama + 'Organization' + (PIR Imms Org ID from vaccine_master) Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  type	Σ	0..1	uriBindingFixed Value	Element id Location.managingOrganization.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments Hardcode as "Organization" Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value Organization Mappings rim: n/a rim: N/A
  identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Location.managingOrganization.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Location.managingOrganization.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  partOf	C	0..1	Reference(Location)	There are no (further) constraints on this element Element id Location.partOf Short description Another Location this one is physically a part of Definition Another Location of which this Location is physically a part of. Requirements For purposes of location, display and identification, knowing which locations are located within other locations is important. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Location) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .inboundLink[typeCode=PART].source[classCode=SDLC]
  id		1..1	string	Element id Location.partOf.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Apply "OrgLOCparentnnn" where "nnn" to be lookup from SDL-Pano Branch table, lookup the parent HA of the location. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Location.partOf.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	0..1	string	There are no (further) constraints on this element Element id Location.partOf.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  type	Σ	0..1	uriBindingFixed Value	Element id Location.partOf.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments Hardcode as "Organization" Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value Organization Mappings rim: n/a rim: N/A
  identifier	Σ	1..1	Identifier	There are no (further) constraints on this element Element id Location.partOf.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  id		0..1	string	There are no (further) constraints on this element Element id Location.partOf.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Location.partOf.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Location.partOf.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Role.code or implied by context
  type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Location.partOf.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments 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. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
  system	Σ	0..1	uri	There are no (further) constraints on this element Element id Location.partOf.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments Identifier.system is always case sensitive. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
  value	Σ	1..1	string	There are no (further) constraints on this element Element id Location.partOf.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments 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 Rendered Value extension. 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 123456 Mappings rim: n/a v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
  period	Σ C	0..1	Period	There are no (further) constraints on this element Element id Location.partOf.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
  assigner	Σ C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Location.partOf.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments 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. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Location.partOf.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  hoursOfOperation		0..1	BackboneElement	There are no (further) constraints on this element Element id Location.hoursOfOperation Short description What days/times during a week is this location usually open Definition What days/times during a week is this location usually open. Comments This type of information is commonly found published in directories and on websites informing customers when the facility is available. Specific services within the location may have their own hours which could be shorter (or longer) than the locations hours. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .effectiveTime
  id		0..1	string	There are no (further) constraints on this element Element id Location.hoursOfOperation.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Location.hoursOfOperation.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Location.hoursOfOperation.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  daysOfWeek		0..*	codeBinding	There are no (further) constraints on this element Element id Location.hoursOfOperation.daysOfWeek Short description mon | tue | wed | thu | fri | sat | sun Definition Indicates which days of the week are available between the start and end Times. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding The days of the week. DaysOfWeek (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .effectiveTime
  allDay		0..1	boolean	There are no (further) constraints on this element Element id Location.hoursOfOperation.allDay Short description The Location is open all day Definition The Location is open all day. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .effectiveTime
  openingTime		0..1	time	There are no (further) constraints on this element Element id Location.hoursOfOperation.openingTime Short description Time that the Location opens Definition Time that the Location opens. Data type time Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .effectiveTime
  closingTime		0..1	time	There are no (further) constraints on this element Element id Location.hoursOfOperation.closingTime Short description Time that the Location closes Definition Time that the Location closes. Data type time Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .effectiveTime
  availabilityExceptions		0..1	string	There are no (further) constraints on this element Element id Location.availabilityExceptions Short description Description of availability exceptions Definition A description of when the locations opening ours are different to normal, e.g. public holiday availability. Succinctly describing all possible exceptions to normal site availability as detailed in the opening hours Times. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  endpoint	C	0..1	Reference(Endpoint)	There are no (further) constraints on this element Element id Location.endpoint Short description Technical endpoints providing access to services operated for the location Definition Technical endpoints providing access to services operated for the location. Requirements Organizations may have different systems at different locations that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Endpoint) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

• Immunization

  The Immunization resource records the immunization event, including the vaccine administered, the patient receiving the immunization, and other pertinent details such as lot number and expiration date. It represents both current and historical immunization data, providing a complete record of a patient’s immunization history. This data is essential for tracking the vaccines received by a patient over time, supporting clinical decision-making, and ensuring compliance with immunization schedules. The patient and location references are mapped to corresponding records stored as part of the immunization bundle.

  Immunization	C		Immunization	Element id Immunization Short description FHIR resource applies for PIR Immunization History Definition FHIR resource applies for PIR Immunization History Data type Immunization Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act workflow: Event v2: VXU_V04 rim: SubstanceAdministration
  id	Σ	1..1	id	Element id Immunization.id Short description PIR Internal Immunization ID Definition PIR Internal Immunization ID Comments See Mappings Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a source-PIR: PIR Imms ID source-PHSL: immunizationId
  meta	Σ	1..1	Meta	There are no (further) constraints on this element Element id Immunization.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  id		0..1	string	There are no (further) constraints on this element Element id Immunization.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  versionId	Σ	0..1	id	Element id Immunization.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments Apply "2025.01.1". This indicates the FHIR Specs as of year 2025 Jan. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastUpdated	Σ	0..1	instant	Element id Immunization.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments Updated: Relax the previously crossed-out elements. Data type instant Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  source	Σ	0..1	uri	There are no (further) constraints on this element Element id Immunization.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  profile	Σ	1..1	canonical(StructureDefinition)	Element id Immunization.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments Use 'http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Immunization' Data type canonical(StructureDefinition) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  security	Σ	0..1	CodingBinding	There are no (further) constraints on this element Element id Immunization.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  tag	Σ	0..1	Coding	There are no (further) constraints on this element Element id Immunization.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Immunization.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..1	codeBinding	There are no (further) constraints on this element Element id Immunization.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Binding extensions MaxValueSet AllLanguages Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..1	Narrative	There are no (further) constraints on this element Element id Immunization.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		0..1	Resource	There are no (further) constraints on this element Element id Immunization.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
  extension	C	2..*	Extension	There are no (further) constraints on this element Element id Immunization.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  antigenDose	C	0..*	Extension(Complex)	Element id Immunization.extension:antigenDose Short description Antgien(s) + Antigen Dose Number + Antigen Dose Status associated with the Agent administered Alternate names extensions, user content Definition Antgien(s) + Antigen Dose Number + Antigen Dose Status associated with the Agent administered Comments To apply for antigens information Data type Extension(Complex) Extension URL ImmzAntigenExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRIdentifierExtension	C	1..1	Extension(string)	Element id Immunization.extension:pIRIdentifierExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(string) Extension URL PIRIdentifierExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRLockSeqNumberExtension	C	1..1	Extension(integer)	Element id Immunization.extension:pIRLockSeqNumberExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(integer) Extension URL PIRLockSeqNumberExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	?! C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  identifier		1..*	Identifier	Element id Immunization.identifier Short description PIR internal Immunization Identifier + External Immunization ID from source system(s) Definition PIR Immunization Identifier(s) which include Panorama Internal Immunization ID, External Immunization ID from different source systems). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier workflow: Event.identifier w5: FiveWs.identifier rim: .id cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/id
  id		0..1	string	There are no (further) constraints on this element Element id Immunization.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Immunization.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Role.code or implied by context
  type	Σ	1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Immunization.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments 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. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.identifier.type.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.identifier.type.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	0..0	Coding	There are no (further) constraints on this element Element id Immunization.identifier.type.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  text	Σ	1..1	string	Element id Immunization.identifier.type.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: PANORAMAIMMZID' source-NHA: NHACEDARIMMS source-VCH: VCHPARISIMMS source-FHA: FHAPARISIMMS source-PNet: PHARMANETIMMS source-CznSub: CZNSUBIMMSID source-immsBC: HEALTHCONNECT source-eForms: EFORMIMMSID
  system	Σ	1..1	uri	Element id Immunization.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType source-PIR: https://health.gov.bc.ca/fhir/NamingSystem/ca-bc-panorama-immunization-id source-NHA: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-nha source-FHA: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-fha source-VCH: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-vcha source-PNet: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-pharmanet-document-number source-CznSub: https://ehealthbc.ca/NamingSystem/ca-bc-citizen-submission source-eForms: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-eForm source-immsBC: https://ehealthbc.ca/NamingSystem/ca-bc-health-connect
  value	Σ	1..1	string	Element id Immunization.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 123456 Mappings rim: n/a v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value source-PIR: PIR Immunization ID source-FHA: FHA PARIS Immunization ID source-NHA: NHA CeDaR Immunization ID source-VCH: VCH PARIS Immunization ID source-PNet: PharmaNet Immunization ID source-PHSL: immunizationId
  period	Σ C	0..1	Period	There are no (further) constraints on this element Element id Immunization.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
  assigner	Σ C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Immunization.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments 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. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
  status	Σ ?!	1..1	codeBinding	Element id Immunization.status Short description completed | entered-in-error | Definition Indicates the current status of the immunization record. Comments IDS sends "completed" or "entered-in-error" immunization records only. Data type code Binding A set of codes indicating the current status of an Immunization. ImmunizationStatusCodes (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Event.status w5: FiveWs.status rim: statusCode
  statusReason		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.statusReason Short description Reason not done Definition Indicates the reason the immunization event was not performed. Comments This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here. Data type CodeableConcept Binding The reason why a vaccine was not administered. ImmunizationStatusReasonCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.statusReason rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
  vaccineCode	Σ	1..1	CodeableConcept	Element id Immunization.vaccineCode Short description Vaccine product administered Definition Vaccine that was administered. Comments 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. Data type CodeableConcept Binding The code for vaccine product administered. VaccineAdministeredValueSet (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.code w5: FiveWs.what[x] v2: RXA-5 rim: .code cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/realmCode/code
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccineCode.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	0..*	Coding	Element id Immunization.vaccineCode.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Slicing Unordered, Open, by code(Value) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  (All Slices)				The requirements in this element apply to all slices
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	0..1	uri	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 reference to some definition that establishes the system clearly and unambiguously. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	0..1	code	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  AgentNVC	Σ	1..1	Coding	Element id Immunization.vaccineCode.coding:AgentNVC Short description Agent administered Definition Agent code and name in NVC Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentNVC.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentNVC.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id Immunization.vaccineCode.coding:AgentNVC.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem code-NVC: https://nvc-cnv.canada.ca code-SNOMED: http://snomed.info/sct
  version	Σ	0..0	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentNVC.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id Immunization.vaccineCode.coding:AgentNVC.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments See Mappings Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code source-PIR: BCYREPORTING.RBCY_FN_GET_CONCEPT_CODE(H33_VACCINATION_MASTER_ASIIS_VACC_CODE) source-PHSL: immunizationAgentCode
  display	Σ	1..1	string	Element id Immunization.vaccineCode.coding:AgentNVC.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName source-PIR: REPORTING.GET_ITERM_DESC(H33_VACCINATION_MASTER_ASIIS_VACC_CODE) source-PHSL: immunizationAgentDescription
  userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentNVC.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  AgentPIR	Σ	0..1	Coding	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentPIR Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentPIR.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentPIR.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id Immunization.vaccineCode.coding:AgentPIR.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem code-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code
  version	Σ	0..0	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentPIR.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentPIR.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	1..1	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentPIR.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentPIR.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  Tradename	Σ	0..1	Coding	Element id Immunization.vaccineCode.coding:Tradename Short description Tradename administered Definition Tradename of agent administered Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Tradename of agent administered Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:Tradename.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:Tradename.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id Immunization.vaccineCode.coding:Tradename.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem code-CVC: https://cvc.canimmunize.ca code-SNOMED: http://snomed.info/sct
  version	Σ	0..0	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:Tradename.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id Immunization.vaccineCode.coding:Tradename.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments See Mappings Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code source-PIR: BCYREPORTNG.RBCY_FN_GET_CONCEPT_CODE (H33_VACCINATION_MASTER.ASIIS_VACC_CODE) source-PHSL: tradeName
  display	Σ	0..1	string	Element id Immunization.vaccineCode.coding:Tradename.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName source-PIR: REPORTNG.GET_ITERM_DESC(H33_VACCINATION_MASTER.ASIIS_VACC_CODE)
  userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:Tradename.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	Element id Immunization.vaccineCode.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: immunizationAgentCombineDescription source-PHSL: immunizationAgentCombineDescription
  patient	Σ C	1..1	Reference(Patient)	There are no (further) constraints on this element Element id Immunization.patient Short description Who was immunized Definition The patient who either received or did not receive the immunization. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Patient) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.subject w5: FiveWs.subject[x] v2: PID-3 rim: .partipication[ttypeCode=].role w5: FiveWs.subject
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.patient.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.patient.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	1..1	string	Element id Immunization.patient.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: fullURL of Panorama + "Patient'+PIR Client ID
  type	Σ	0..0	uriBinding	There are no (further) constraints on this element Element id Immunization.patient.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..0	Identifier	There are no (further) constraints on this element Element id Immunization.patient.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..0	string	There are no (further) constraints on this element Element id Immunization.patient.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  encounter	C	0..1	Reference(Encounter)	There are no (further) constraints on this element Element id Immunization.encounter Short description Encounter immunization was part of Definition The visit or admission or other contact between patient and health care provider the immunization was performed as part of. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Encounter) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.context w5: FiveWs.context v2: PV1-19 rim: component->EncounterEvent
  occurrence[x]	Σ	1..1	dateTime	Element id Immunization.occurrence[x] Short description Vaccine administration date Definition Date vaccine administered Comments See Mappings Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Event.occurrence[x] w5: FiveWs.done[x] v2: RXA-3 rim: .effectiveTime cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value source-PIR: imms.h33_vaccination_master.vacc_date source-PHSL: vaccDate
  id		0..1	string	There are no (further) constraints on this element Element id Immunization.occurrence[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.occurrence[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  _occurrenceDateTime	C	0..*	Extension(boolean)	Element id Immunization.occurrence[x].extension:_occurrenceDateTime Short description Estimated Flag for Vaccination Date Alternate names extensions, user content Definition Estimated Flag for Vaccination Date Comments See Mappings Data type Extension(boolean) Extension URL EstimatedFlagExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A source-PHSL: VM.VACC_DATE_ESTIMATED_IND = 'Y source-PHSL: note="E"
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.occurrence[x].extension:_occurrenceDateTime.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.occurrence[x].extension:_occurrenceDateTime.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Immunization.occurrence[x].extension:_occurrenceDateTime.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value https://ehealthontario.ca/API/FHIR/StructureDefinition/ca-on-extension-estimated-date Mappings rim: N/A
  value[x]		0..1		Element id Immunization.occurrence[x].extension:_occurrenceDateTime.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Comments Apply PIR: H33_VACCINATION_MASTER.VACC_DATE Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  valueBoolean			boolean	There are no (further) constraints on this element Data type boolean
  value		0..1	System.DateTime	There are no (further) constraints on this element Element id Immunization.occurrence[x].value Short description Primitive value for dateTime Definition Primitive value for dateTime Data type System.DateTime
  recorded		0..1	dateTime	There are no (further) constraints on this element Element id Immunization.recorded Short description When the immunization was first captured in the subject's record Definition The date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.recorded rim: .participation[typeCode=AUT].time
  primarySource	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.primarySource Short description Indicates context the data was recorded in Definition An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded. Comments Reflects the “reliability” of the content. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.source v2: RXA-9 rim: immunization.uncertaintycode (if primary source=false, uncertainty=U)
  reportOrigin		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.reportOrigin Short description Indicates the source of a secondarily reported record Definition The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine. Comments Should not be populated if primarySource = True, not required even if primarySource = False. Data type CodeableConcept Binding The source of the data for a record which is not from a primary source. ImmunizationOriginCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.source v2: RXA-9 rim: .participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported) .participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional) .participation[typeCode=INF].role[classCode=PRS] (this syntax for family member)
  location	C	0..1	Reference(Location)	Element id Immunization.location Short description Immunization Service Delivery Location (SDL) Definition Immunization Service Delivery Location (SDL) Comments See Mappings Data type Reference(Location) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.location w5: FiveWs.where[x] v2: RXA-27 (or RXA-11, deprecated as of v2.7) rim: .participation[typeCode=LOC].COCT_MT240000UV source-PHSL: serviceDeliveryLocationName source-PIR: H33_VACCINATION_MASTER.location_id
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.location.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.location.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	1..1	string	Element id Immunization.location.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments fullURL of Panorama + 'Location' + PIR Loc ID + 'org' + PIR Imms Org ID Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  type	Σ	0..0	uriBinding	There are no (further) constraints on this element Element id Immunization.location.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..0	Identifier	There are no (further) constraints on this element Element id Immunization.location.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..0	string	There are no (further) constraints on this element Element id Immunization.location.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  manufacturer	C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Immunization.manufacturer Short description Vaccine manufacturer Definition Name of vaccine manufacturer. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: RXA-17 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=ORG] cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacuturerOrganization/name
  lotNumber		0..1	string	Element id Immunization.lotNumber Short description Vaccine lot number Definition Lot number of the vaccine product. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: RXA-15 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/lotNumberText source-PIR: INV_PRODUCT_LOT_INFO.LOT_NUMBER source-PHSL: lotNumber
  expirationDate		0..1	date	There are no (further) constraints on this element Element id Immunization.expirationDate Short description Vaccine expiration date Definition Date vaccine batch expires. Data type date Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: RXA-16 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime
  site		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.site Short description Body site vaccine was administered Definition Body site where vaccine was administered. Comments 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. Data type CodeableConcept Binding The site at which the vaccine was administered. CodesForImmunizationSiteOfAdministration (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXR-2 rim: observation.targetSiteCode cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/approachSiteCode/code
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.site.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.site.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id Immunization.site.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.site.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.site.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	0..1	uri	Element id Immunization.site.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments Use 'http://snomed.info/sct'' Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  version	Σ	0..0	string	There are no (further) constraints on this element Element id Immunization.site.coding.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	0..1	code	Element id Immunization.site.coding.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments Apply SNOMED code Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.site.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Immunization.site.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..0	string	There are no (further) constraints on this element Element id Immunization.site.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments Very often the text is the same as a displayName of one of the codings. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  route		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.route Short description How vaccine entered body Definition The path by which the vaccine product is taken into the body. Comments 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. Data type CodeableConcept Binding The route by which the vaccine was administered. ImmunizationRouteCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXR-1 rim: .routeCode cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/routeCode/code
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.route.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.route.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id Immunization.route.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.route.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.route.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	0..1	uri	Element id Immunization.route.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments Use 'http://snomed.info/sct' Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  version	Σ	0..0	string	There are no (further) constraints on this element Element id Immunization.route.coding.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	0..1	code	Element id Immunization.route.coding.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments Apply SNOMED code Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.route.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Immunization.route.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..0	string	There are no (further) constraints on this element Element id Immunization.route.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments Very often the text is the same as a displayName of one of the codings. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  doseQuantity	C	0..1	SimpleQuantity	There are no (further) constraints on this element Element id Immunization.doseQuantity Short description Amount of vaccine administered Definition The quantity of vaccine product that was administered. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type SimpleQuantity Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) qty-3: If a code for the unit is present, the system SHALL also be present code.empty() or system.exists() sqty-1: The comparator is not used on a SimpleQuantity comparator.empty() Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values v2: RXA-6 / RXA-7 rim: .doseQuantity
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.doseQuantity.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.doseQuantity.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  value	Σ	0..1	decimal	Element id Immunization.doseQuantity.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value. Requirements Precision is handled implicitly in almost all cases of measurement. Comments See Mappings Data type decimal Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: SN.2 / CQ - N/A rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value source-PIR: H33_VACCINATION_MASTER.CC_VOLUME source-PHSL: dosage
  comparator	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id Immunization.doseQuantity.comparator Short description < | <= | >= | > - how to understand the value Definition Not allowed to be used in this context Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: SN.1 / CQ.1 rim: IVL properties
  unit	Σ	0..1	string	Element id Immunization.doseQuantity.unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit source-PIR: H33_VACCINATION_MASTER.DOSAGE_UOM_CNCPT_ID source-PHSL: dosageUOMDescription
  system	Σ C	0..0	uri	There are no (further) constraints on this element Element id Immunization.doseQuantity.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1, qty-3 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
  code	Σ	0..0	code	There are no (further) constraints on this element Element id Immunization.doseQuantity.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. Requirements Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. Comments The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code
  performer	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id Immunization.performer Short description Who performed event Definition Indicates who performed the immunization event. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Event.performer v2: ORC-12 / RXA-10 rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
  id		0..1	string	There are no (further) constraints on this element Element id Immunization.performer.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.performer.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.performer.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  function	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Immunization.performer.function Short description What type of performance was done Definition Describes the type of performance (e.g. ordering provider, administering provider, etc.). Comments 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. Data type CodeableConcept Binding The role a practitioner or organization plays in the immunization event. ImmunizationFunctionCodes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.performer.function rim: .participation.functionCode
  actor	Σ C	1..1	Reference(Organization | Practitioner | PractitionerRole)	Element id Immunization.performer.actor Short description Provider who administered the vaccine Definition Provider who administered the vaccine Comments When the individual practitioner who performed the action is known, it is best to send. Data type Reference(Organization | Practitioner | PractitionerRole) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.performer.actor w5: FiveWs.actor rim: .player
  id		0..1	string	There are no (further) constraints on this element Element id Immunization.performer.actor.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.performer.actor.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	0..1	string	Element id Immunization.performer.actor.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments fullURL of Panorama + 'Practitioner' + PIR Provider ID Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id Immunization.performer.actor.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Immunization.performer.actor.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.performer.actor.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  note	Σ	0..*	Annotation	Element id Immunization.note Short description Additional immunization notes Definition Extra information about the immunization that is not conveyed by the other attributes. Comments See Mappings Data type Annotation Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act workflow: Event.note v2: OBX-5 : OBX-3 = 48767-8 rim: note source-PIR: IMMUNIZATION_COMMENT.COMMENT_TEXT source-PHSL: commentText
  id		0..1	string	There are no (further) constraints on this element Element id Immunization.note.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	2..*	Extension	There are no (further) constraints on this element Element id Immunization.note.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRIdentifierExtension	C	1..1	Extension(string)	Element id Immunization.note.extension:pIRIdentifierExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(string) Extension URL PIRIdentifierExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRLockSeqNumberExtension	C	1..1	Extension(integer)	Element id Immunization.note.extension:pIRLockSeqNumberExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(integer) Extension URL PIRLockSeqNumberExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  author[x]	Σ	0..1		There are no (further) constraints on this element Element id Immunization.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Comments Organization is used when there's no need for specific attribution as to who made the comment. Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act.participant[typeCode=AUT].role
  authorReference			Reference(Organization | Patient | Practitioner | RelatedPerson)	There are no (further) constraints on this element Data type Reference(Organization | Patient | Practitioner | RelatedPerson)
  authorString			string	There are no (further) constraints on this element Data type string
  time	Σ	0..1	dateTime	There are no (further) constraints on this element Element id Immunization.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act.effectiveTime
  text	Σ	1..1	markdown	There are no (further) constraints on this element Element id Immunization.note.text Short description The annotation - text content (as markdown) Definition The text of the annotation in markdown format. Comments Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/ Data type markdown Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act.text
  reasonCode		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.reasonCode Short description Why immunization occurred Definition Reasons why the vaccine was administered. Comments 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. Data type CodeableConcept Binding The reason why a vaccine was administered. ImmunizationReasonCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.reasonCode rim: [actionNegationInd=false].reasonCode
  reasonReference	C	0..1	Reference(Condition | DiagnosticReport | Observation)	There are no (further) constraints on this element Element id Immunization.reasonReference Short description Why immunization occurred Definition Condition, Observation or DiagnosticReport that supports why the immunization was administered. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Condition | DiagnosticReport | Observation) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.reasonReference rim: N/A
  isSubpotent	Σ ?!	0..1	boolean	Element id Immunization.isSubpotent Short description Dose potency Definition Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent. If dose potency has been overriden, set to "true". Comments See Mappings Meaning when missing By default, a dose should be considered to be potent. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: RXA-20 = PA (partial administration) rim: N/A source-PIR: PIR imms.vaccine_status.status source-PHSL: note="O"
  subpotentReason		0..*	CodeableConcept	Element id Immunization.subpotentReason Short description Reason + Status for being subpotent Definition Reason why a dose is considered to be subpotent and Status. Comments See Mappings Data type CodeableConcept Binding The reason why a dose is considered to be subpotent. ImmunizationSubpotentReason (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: N/A source-PIR: imms.vaccine_status.status_reason
  id		0..1	string	There are no (further) constraints on this element Element id Immunization.subpotentReason.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.subpotentReason.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	1..1	Coding	Element id Immunization.subpotentReason.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Slicing Unordered, Open, by code(Value) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  doseStatusReason	Σ	0..1	Coding	Element id Immunization.subpotentReason.coding:doseStatusReason Short description Slice 1: Dose Status Overriden Reason Definition Dose Status Overriden Reason Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments To be applied when vaccine status = "OI", "OV". Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.subpotentReason.coding:doseStatusReason.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.subpotentReason.coding:doseStatusReason.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id Immunization.subpotentReason.coding:doseStatusReason.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem source-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code
  version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.subpotentReason.coding:doseStatusReason.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	There are no (further) constraints on this element Element id Immunization.subpotentReason.coding:doseStatusReason.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	1..1	string	Element id Immunization.subpotentReason.coding:doseStatusReason.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName source-PIR-doseStatusReason: "Reason - " + BCYREPORTNG.RBCY_FN_GET_AGENT_STATUS(H33_VACCINATION_MASTER.IMMUNIZATION_ID)
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.subpotentReason.coding:doseStatusReason.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  doseStatus	Σ	1..1	Coding	Element id Immunization.subpotentReason.coding:doseStatus Short description Dose Status if overriden Definition Dose Status if overriden (from Valid to Invalid) or (from Invalid to Valid) Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id Immunization.subpotentReason.coding:doseStatus.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.subpotentReason.coding:doseStatus.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id Immunization.subpotentReason.coding:doseStatus.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments Use 'https://ehealth.bc.ca/fhir/CodeSystem/ca-bc-dose-status' Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.subpotentReason.coding:doseStatus.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id Immunization.subpotentReason.coding:doseStatus.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments See Mappings Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code source-PIR: BCYREPORTNG.RBCY_FN_GET_AGENT_STATUS source-PHSL: agentOverrideStatus
  display	Σ	1..1	string	Element id Immunization.subpotentReason.coding:doseStatus.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName source-PIR-status: "Status - " + BCYREPORTNG.RBCY_FN_GET_AGENT_STATUS (VM.IMMUNIZATION_ID) = 'Valid (override)'
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.subpotentReason.coding:doseStatus.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	Element id Immunization.subpotentReason.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments To be applied when vaccine status = "FI" Forecaster Invalid. PIR Forecaster invalidated the imms record for the following possible reasons: Non-WHO approved tradename Administered prior to eligibility – interval or age Additional dose resulting from use of multi-antigen agent Client administered with same agent on same day Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  education	C	0..1	BackboneElement	There are no (further) constraints on this element Element id Immunization.education Short description Educational material presented to patient Definition Educational material presented to the patient (or guardian) at the time of vaccine administration. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) imm-1: One of documentType or reference SHALL be present documentType.exists() or reference.exists() Mappings rim: n/a rim: N/A
  id		0..1	string	There are no (further) constraints on this element Element id Immunization.education.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.education.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.education.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  documentType		0..1	string	There are no (further) constraints on this element Element id Immunization.education.documentType Short description Educational material document identifier Definition Identifier of the material presented to the patient. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: OBX-5 : OBX-3 = 69764-9 rim: N/A
  reference		0..1	uri	There are no (further) constraints on this element Element id Immunization.education.reference Short description Educational material reference pointer Definition Reference pointer to the educational material given to the patient if the information was on line. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  publicationDate		0..1	dateTime	There are no (further) constraints on this element Element id Immunization.education.publicationDate Short description Educational material publication date Definition Date the educational material was published. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: OBX-5 : OBX-3 = 29768-9 rim: N/A
  presentationDate		0..1	dateTime	There are no (further) constraints on this element Element id Immunization.education.presentationDate Short description Educational material presentation date Definition Date the educational material was given to the patient. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: OBX-5 : OBX-3 = 29769-7 rim: N/A
  programEligibility		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.programEligibility Short description Patient eligibility for a vaccination program Definition Indicates a patient's eligibility for a funding program. Comments 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. Data type CodeableConcept Binding The patient's eligibility for a vaccation program. ImmunizationProgramEligibility (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: OBX-5 : OBX-3 = 64994-7 rim: N/A
  fundingSource		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.fundingSource Short description Funding source for the vaccine Definition Indicates the source of the vaccine actually administered. This may be different than the patient eligibility (e.g. the patient may be eligible for a publically purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered). Comments 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. Data type CodeableConcept Binding The source of funding used to purchase the vaccine administered. ImmunizationFundingSource (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: N/A
  reaction		0..1	BackboneElement	There are no (further) constraints on this element Element id Immunization.reaction Short description Details of a reaction that follows immunization Definition Categorical data indicating that an adverse event is associated in time to an immunization. Comments A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: OBX-3 rim: Observation[classCode=obs].code
  id		0..1	string	There are no (further) constraints on this element Element id Immunization.reaction.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.reaction.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.reaction.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  date		0..1	dateTime	There are no (further) constraints on this element Element id Immunization.reaction.date Short description When reaction started Definition Date of reaction to the immunization. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: OBX-14 (ideally this would be reported in an IAM segment, but IAM is not part of the HL7 v2 VXU message - most likely would appear in OBX segments if at all) rim: .effectiveTime
  detail	C	0..1	Reference(Observation)	There are no (further) constraints on this element Element id Immunization.reaction.detail Short description Additional information on reaction Definition Details of the reaction. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Observation) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: OBX-5 rim: .value
  reported		0..1	boolean	There are no (further) constraints on this element Element id Immunization.reaction.reported Short description Indicates self-reported reaction Definition Self-reported indicator. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: (HL7 v2 doesn't seem to provide for this) rim: .participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)
  protocolApplied		0..*	BackboneElement	Element id Immunization.protocolApplied Short description Dose Number or Revised Dose Number Definition Dose Number or Revised Dose Number Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.protocolApplied.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.protocolApplied.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.protocolApplied.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  series		0..0	string	There are no (further) constraints on this element Element id Immunization.protocolApplied.series Short description Name of vaccine series Definition One possible path to achieve presumed immunity against a disease - within the context of an authority. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  authority	C	0..0	Reference(Organization)	There are no (further) constraints on this element Element id Immunization.protocolApplied.authority Short description Who is responsible for publishing the recommendations Definition Indicates the authority who published the protocol (e.g. ACIP) that is being followed. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: N/A
  targetDisease		0..0	CodeableConcept	There are no (further) constraints on this element Element id Immunization.protocolApplied.targetDisease Short description Vaccine preventatable disease being targetted Definition The vaccine preventable disease the dose is being administered against. Comments 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. Data type CodeableConcept Binding The vaccine preventable disease the dose is being administered for. ImmunizationTargetDiseaseCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: N/A
  doseNumber[x]		1..1	string	Element id Immunization.protocolApplied.doseNumber[x] Short description Dose number within series Definition Nominal position in a series based on Antigen. Comments Dose Number based on Antigen Level. See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: BCYREPORTNG.RBCY_FN_GET_AGENT_DOSE_NUM(VM.IMMUNIZATION_ID) source-PHSL: agentDoseNumber
  id		0..1	string	There are no (further) constraints on this element Element id Immunization.protocolApplied.doseNumber[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Immunization.protocolApplied.doseNumber[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  _doseNumber	C	0..1	Extension(Complex)	Element id Immunization.protocolApplied.doseNumber[x].extension:_doseNumber Short description Revised Dose Number + Reason + comments Alternate names extensions, user content Definition Revised Dose Number + Reason + comments Comments To apply when there is revised dose number in PIR. Data type Extension(Complex) Extension URL ImmzReviseDoseExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  value		0..1	System.String	There are no (further) constraints on this element Element id Immunization.protocolApplied.doseNumber[x].value Short description Primitive value for string Definition Primitive value for string Data type System.String Maximum string length 1048576
  seriesDoses[x]		0..0		There are no (further) constraints on this element Element id Immunization.protocolApplied.seriesDoses[x] Short description Recommended number of doses for immunity Definition The recommended number of doses to achieve immunity. Comments The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A

• AdverseEvent

  The AdverseEvent resource captures any adverse reactions reported following an immunization. This resource includes details such as the severity of the event, the patient affected, and the suspected cause. The event data helps to monitor vaccine safety and patient outcomes.

  AdverseEvent	C		AdverseEvent	Element id AdverseEvent Short description FHIR resource applies for PIR AEFI Alternate names AE Definition FHIR resource applies for PIR AEFI Data type AdverseEvent Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act
  id	Σ	1..1	id	Element id AdverseEvent.id Short description PIR Internal AEFI ID Definition PIR Internal AEFI Identifier Comments See Mappings Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a source-PIR: IMMS.ADVERSE_EVENT.ADVERSE_EVENT_ID source-PHSL: adverseEventId
  meta	Σ	1..1	Meta	There are no (further) constraints on this element Element id AdverseEvent.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  id		0..1	string	There are no (further) constraints on this element Element id AdverseEvent.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id AdverseEvent.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  versionId	Σ	0..1	id	Element id AdverseEvent.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments Apply "2025.01.1". This indicates the FHIR Specs as of year 2025 January. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastUpdated	Σ	0..1	instant	Element id AdverseEvent.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments Updated: Relax the previously crossed-out elements. Data type instant Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  source	Σ	0..1	uri	There are no (further) constraints on this element Element id AdverseEvent.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  profile	Σ	1..1	canonical(StructureDefinition)	Element id AdverseEvent.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments Apply "http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/AdverseEvent" Data type canonical(StructureDefinition) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  security	Σ	0..1	CodingBinding	There are no (further) constraints on this element Element id AdverseEvent.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  tag	Σ	0..1	Coding	There are no (further) constraints on this element Element id AdverseEvent.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id AdverseEvent.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..1	codeBinding	There are no (further) constraints on this element Element id AdverseEvent.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Binding extensions MaxValueSet AllLanguages Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..1	Narrative	There are no (further) constraints on this element Element id AdverseEvent.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		0..1	Resource	There are no (further) constraints on this element Element id AdverseEvent.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
  extension	C	2..*	Extension	There are no (further) constraints on this element Element id AdverseEvent.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  AEFIpublicHealthRecomm	C	0..*	Extension(Complex)	Element id AdverseEvent.extension:AEFIpublicHealthRecomm Short description Public Health Recommendation(s) for AEFI Alternate names extensions, user content Definition Public Health Recommendation(s) for AEFI Comments Version 2024.4: Send DateTime for element phrDate. Data type Extension(Complex) Extension URL AEFIpublicHealthRecomm Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  phrRecommendations	C	0..*	Extension	Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrRecommendations Short description AEFI Public Health Recommendations Alternate names extensions, user content Definition AEFI Public Health Recommendations Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A source-PIR: NOCHANGE_CD_CNCPT_ID source-PHSL: pubHealthRecomm
  id		0..0	string	There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrRecommendations.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..0	Extension	There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrRecommendations.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrRecommendations.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value phrRecommendations Mappings rim: N/A
  value[x]		1..1		There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrRecommendations.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  valueAnnotation			Annotation	There are no (further) constraints on this element Data type Annotation
  phrDate	C	0..*	Extension	Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrDate Short description AEFI Public Health Recommendations Date Alternate names extensions, user content Definition AEFI Public Health Recommendations Date Comments See Mappings Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A source-PIR: REPORTNG.AE_EVENT_RECOMMENDATION.CREATED_ON source-PHSL: pubDate
  id		0..0	string	There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrDate.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..0	Extension	There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrDate.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrDate.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value phrDate Mappings rim: N/A
  value[x]		1..1		There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrDate.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Comments See Mappings Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: REPORTNG.AE_EVENT_RECOMMENDATION.CREATED_ON
  valueDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
  phrComment	C	0..*	Extension	Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrComment Short description AEFI Public Health Recommendations Comments Alternate names extensions, user content Definition AEFI Public Health Recommendations Comments Comments See Mappings Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A source-PIR: IMMUNIZATION_COMMENT.COMMENT_TEXT source-PHSL: phrComment
  id		0..0	string	There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrComment.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..0	Extension	There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrComment.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrComment.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value phrComment Mappings rim: N/A
  value[x]		1..1	string	There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrComment.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Comments See Mappings. Only applies to adverse event recommendation comment types, i.e.,where reportng.ae_event_recommendation.ae_event_recommendation_id = immunization_comment.row_id AND comment_type = 'AE' AND comment_subtype = 'RECOMM' Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: IMMUNIZATION_COMMENT.COMMENT_TEXT
  id		0..1	string	There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrComment.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	2..*	Extension	There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrComment.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRIdentifierExtension	C	1..1	Extension(string)	There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrComment.value[x].extension:pIRIdentifierExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(string) Extension URL PIRIdentifierExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRLockSeqNumberExtension	C	1..1	Extension(integer)	There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrComment.value[x].extension:pIRLockSeqNumberExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(integer) Extension URL PIRLockSeqNumberExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  value		0..1	System.String	There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.extension:phrComment.value[x].value Short description Primitive value for string Definition Primitive value for string Data type System.String Maximum string length 1048576
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/AEFI-publicHealth-recomm Mappings rim: N/A
  value[x]		0..0		There are no (further) constraints on this element Element id AdverseEvent.extension:AEFIpublicHealthRecomm.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  pIRIdentifierExtension	C	1..1	Extension(string)	Element id AdverseEvent.extension:pIRIdentifierExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(string) Extension URL PIRIdentifierExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRLockSeqNumberExtension	C	1..1	Extension(integer)	Element id AdverseEvent.extension:pIRLockSeqNumberExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(integer) Extension URL PIRLockSeqNumberExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	?! C	0..*	Extension	There are no (further) constraints on this element Element id AdverseEvent.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  identifier	Σ	1..1	Identifier	Element id AdverseEvent.identifier Short description PIR Internal AEFI ID + External AEFI ID from source system(s) Definition PIR Internal AEFI ID + External AEFI ID from source system(s) Requirements Allows identification of the adverse event as it is known by various participating systems and in a way that remains consistent across servers. Comments This is a business identifier, not a resource identifier (see discussion). 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. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier
  id		0..0	string	There are no (further) constraints on this element Element id AdverseEvent.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id AdverseEvent.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  use	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id AdverseEvent.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Role.code or implied by context
  type	Σ	1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id AdverseEvent.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments 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. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
  id		0..0	string	There are no (further) constraints on this element Element id AdverseEvent.identifier.type.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id AdverseEvent.identifier.type.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	0..0	Coding	There are no (further) constraints on this element Element id AdverseEvent.identifier.type.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  text	Σ	1..1	string	Element id AdverseEvent.identifier.type.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: PANORAMAIMMZAEFIID
  system	Σ	1..1	uri	Element id AdverseEvent.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType source-PIR: https://health.gov.bc.ca/fhir/NamingSystem/ca-bc-panorama-immunization-AEFI-id
  value	Σ	1..1	string	Element id AdverseEvent.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 123456 Mappings rim: n/a v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value source-PIR: IMMS.ADVERSE_EVENT.ADVERSE_EVENT_ID source-PHSL: adverseEventId
  period	Σ C	0..0	Period	There are no (further) constraints on this element Element id AdverseEvent.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
  assigner	Σ C	0..0	Reference(Organization)	There are no (further) constraints on this element Element id AdverseEvent.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments 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. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
  actuality	Σ ?!	1..1	codeBinding	Element id AdverseEvent.actuality Short description actual | potential Definition Whether the event actually happened, or just had the potential to. Comments Apply "actual" for PIR. Data type code Binding Overall nature of the adverse event, e.g. real or potential. AdverseEventActuality (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.class
  id		0..1	string	There are no (further) constraints on this element Element id AdverseEvent.actuality.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	1..*	Extension	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  _actuality	C	1..1	Extension(Complex)	Element id AdverseEvent.actuality.extension:_actuality Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments To apply for AEFI status and delete reason Data type Extension(Complex) Extension URL AEFIstatusReason Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	1..*	Extension	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  AEFIstatus	C	1..1	Extension	Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIstatus Short description AEFI Status Alternate names extensions, user content Definition AEFI Status Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIstatus.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIstatus.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIstatus.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value AEFIstatus Mappings rim: N/A
  value[x]		1..1	CodeableConcept	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIstatus.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Data type CodeableConcept Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIstatus.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIstatus.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	1..1	Coding	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIstatus.value[x].coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..0	string	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIstatus.value[x].coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIstatus.value[x].coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIstatus.value[x].coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem source-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code
  version	Σ	0..0	string	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIstatus.value[x].coding.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIstatus.value[x].coding.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments See Mappings Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code source-PIR: ADVERSE_EVENT.STATUS_CODED_CNCPT_ID source-PHSL: status
  display	Σ	0..1	string	Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIstatus.value[x].coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments See MAppings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName source-PIR: ADVERSE_EVENT.STATUS_CODED_CNCPT_ID source-PHSL: statusDescription
  userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIstatus.value[x].coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..0	string	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIstatus.value[x].text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments Very often the text is the same as a displayName of one of the codings. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  AEFIdeleteReason	C	0..*	Extension	Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIdeleteReason Short description AEFI deleted reason Alternate names extensions, user content Definition AEFI deleted reason Comments To be apply when AEFI has status = Disregard, Entered in Error or NO reason provided. See Mappings Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A source-PIR-nullReason: Other
  id		0..0	string	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIdeleteReason.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIdeleteReason.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIdeleteReason.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value AEFIdeleteReason Mappings rim: N/A
  value[x]		1..1		There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIdeleteReason.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  valueString			string	There are no (further) constraints on this element Data type string
  AEFIdeleteReasonOther	C	0..*	Extension	Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIdeleteReasonOther Short description AEFI deleted reason = Other, specify Alternate names extensions, user content Definition AEFI deleted reason = Other, specify Comments To be apply when AEFI status has OTHER reason or NO reason provided. See Mappings. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A source-PIR-null: unknown
  id		0..0	string	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIdeleteReasonOther.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIdeleteReasonOther.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIdeleteReasonOther.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value AEFIdeleteReasonOther Mappings rim: N/A
  value[x]		1..1		There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.extension:AEFIdeleteReasonOther.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  valueString			string	There are no (further) constraints on this element Data type string
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/AEFI-status-reason Mappings rim: N/A
  value[x]		0..0		There are no (further) constraints on this element Element id AdverseEvent.actuality.extension:_actuality.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  value		0..1	System.String	There are no (further) constraints on this element Element id AdverseEvent.actuality.value Short description Primitive value for code Definition Primitive value for code Data type System.String Maximum string length 1048576
  category	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id AdverseEvent.category Short description product-problem | product-quality | product-use-error | wrong-dose | incorrect-prescribing-information | wrong-technique | wrong-route-of-administration | wrong-rate | wrong-duration | wrong-time | expired-drug | medical-device-use-error | problem-different-manufacturer | unsafe-physical-environment Definition The overall type of event, intended for search and filtering purposes. Comments 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. Data type CodeableConcept Binding Overall categorization of the event, e.g. product-related or situational. AdverseEventCategory (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.class
  event	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id AdverseEvent.event Short description Type of the event itself in relation to the subject Definition This element defines the specific type of event that occurred or that was prevented from occurring. Comments 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. Data type CodeableConcept Binding Detailed type of event. SNOMEDCTClinicalFindings (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.what[x]
  subject	Σ C	1..1	Reference(Group | Patient | Practitioner | RelatedPerson)	There are no (further) constraints on this element Element id AdverseEvent.subject Short description Subject impacted by event Alternate names patient Definition This subject or group impacted by the event. Requirements Allows for exposure of biohazard (such as legionella) to a group of individuals in a hospital. Comments If AdverseEvent.resultingCondition differs among members of the group, then use Patient as the subject. Data type Reference(Group | Patient | Practitioner | RelatedPerson) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.who
  id		0..0	string	There are no (further) constraints on this element Element id AdverseEvent.subject.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id AdverseEvent.subject.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	1..1	string	Element id AdverseEvent.subject.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: fullURL of Panorama + "Patient" + PIR Client ID
  type	Σ	0..0	uriBinding	There are no (further) constraints on this element Element id AdverseEvent.subject.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..0	Identifier	There are no (further) constraints on this element Element id AdverseEvent.subject.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..0	string	There are no (further) constraints on this element Element id AdverseEvent.subject.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  encounter	Σ C	0..1	Reference(Encounter)	There are no (further) constraints on this element Element id AdverseEvent.encounter Short description Encounter created as part of Definition The Encounter during which AdverseEvent was created or to which the creation of this record is tightly associated. Comments 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. For example, if a medication administration was considered an adverse event because it resulted in a rash, then the encounter when the medication administration was given is the context. If the patient reports the AdverseEvent during a second encounter, that second encounter is not the context. Data type Reference(Encounter) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.context
  date	Σ	0..1	dateTime	There are no (further) constraints on this element Element id AdverseEvent.date Short description When the event occurred Definition The date (and perhaps time) when the adverse event occurred. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.init
  detected	Σ	0..1	dateTime	There are no (further) constraints on this element Element id AdverseEvent.detected Short description When the event was detected Definition Estimated or actual date the AdverseEvent began, in the opinion of the reporter. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  recordedDate	Σ	1..1	dateTime	Element id AdverseEvent.recordedDate Short description When the event was recorded Definition The date on which the existence of the AdverseEvent was first recorded. Comments See Mappings Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.recorded source-PIR: IMMS.ADVERSE_EVENT.DATE_REPORTED source-PHSL: dateReported
  resultingCondition	Σ C	0..1	Reference(Condition)	There are no (further) constraints on this element Element id AdverseEvent.resultingCondition Short description Effect on the subject due to this event Definition Includes information about the reaction that occurred as a result of exposure to a substance (for example, a drug or a chemical). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Condition) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  location	Σ C	0..1	Reference(Location)	There are no (further) constraints on this element Element id AdverseEvent.location Short description Location where adverse event occurred Definition The information about where the adverse event occurred. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Location) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  seriousness	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id AdverseEvent.seriousness Short description Seriousness of the event Definition Assessment whether this event was of real importance. Comments 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. Data type CodeableConcept Binding Overall seriousness of this event for the patient. AdverseEventSeriousness (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  severity	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id AdverseEvent.severity Short description mild | moderate | severe Definition Describes the severity of the adverse event, in relation to the subject. Contrast to AdverseEvent.seriousness - a severe rash might not be serious, but a mild heart problem is. Comments 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. Data type CodeableConcept Binding The severity of the adverse event itself, in direct relation to the subject. AdverseEventSeverity (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  outcome	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id AdverseEvent.outcome Short description resolved | recovering | ongoing | resolvedWithSequelae | fatal | unknown Definition Describes the type of outcome from the adverse event. Comments 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. Data type CodeableConcept Binding TODO (and should this be required?). AdverseEventOutcome (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  recorder	Σ C	0..1	Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)	There are no (further) constraints on this element Element id AdverseEvent.recorder Short description Who recorded the adverse event Definition Information on who recorded the adverse event. May be the patient or a practitioner. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Patient | Practitioner | PractitionerRole | RelatedPerson) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.author
  contributor	Σ C	0..1	Reference(Device | Practitioner | PractitionerRole)	There are no (further) constraints on this element Element id AdverseEvent.contributor Short description Who was involved in the adverse event or the potential adverse event Definition Parties that may or should contribute or have contributed information to the adverse event, which can consist of one or more activities. Such information includes information leading to the decision to perform the activity and how to perform the activity (e.g. consultant), information that the activity itself seeks to reveal (e.g. informant of clinical history), or information about what activity was performed (e.g. informant witness). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Device | Practitioner | PractitionerRole) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  suspectEntity	Σ	1..*	BackboneElement	Element id AdverseEvent.suspectEntity Short description The suspected agent causing the adverse event Definition Describes the vaccine that is suspected to have caused the adverse event. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  id		0..0	string	Element id AdverseEvent.suspectEntity.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Apply PIR: IMMS.AE_VACCINATION.IMMUNIZATION_ID Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id AdverseEvent.suspectEntity.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id AdverseEvent.suspectEntity.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  instance	Σ C	1..1	Reference(Device | Immunization | Medication | MedicationAdministration | MedicationStatement | Procedure | Substance)	There are no (further) constraints on this element Element id AdverseEvent.suspectEntity.instance Short description Refers to the specific entity that caused the adverse event Alternate names Substance or Medication or Device Definition Identifies the actual instance of what caused the adverse event. May be a substance, medication, medication administration, medication statement or a device. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Device | Immunization | Medication | MedicationAdministration | MedicationStatement | Procedure | Substance) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  id		0..0	string	There are no (further) constraints on this element Element id AdverseEvent.suspectEntity.instance.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id AdverseEvent.suspectEntity.instance.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	1..1	string	Element id AdverseEvent.suspectEntity.instance.reference Short description Reference the resourceImmunization with the AEFI vaccine Definition Reference the resourceImmunization with the AEFI vaccine Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: fullURL of Panorama + 'Immunization' + (PIR Imms ID) source-PHSL: adverseEventAssociatedImmsId
  type	Σ	0..0	uriBinding	There are no (further) constraints on this element Element id AdverseEvent.suspectEntity.instance.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..0	Identifier	There are no (further) constraints on this element Element id AdverseEvent.suspectEntity.instance.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..0	string	There are no (further) constraints on this element Element id AdverseEvent.suspectEntity.instance.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  causality	Σ	0..0	BackboneElement	There are no (further) constraints on this element Element id AdverseEvent.suspectEntity.causality Short description Information on the possible cause of the event Definition Information on the possible cause of the event. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  subjectMedicalHistory	Σ C	0..1	Reference(AllergyIntolerance | Condition | DocumentReference | FamilyMemberHistory | Immunization | Media | Observation | Procedure)	There are no (further) constraints on this element Element id AdverseEvent.subjectMedicalHistory Short description AdverseEvent.subjectMedicalHistory Definition AdverseEvent.subjectMedicalHistory. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(AllergyIntolerance | Condition | DocumentReference | FamilyMemberHistory | Immunization | Media | Observation | Procedure) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  referenceDocument	Σ C	0..1	Reference(DocumentReference)	There are no (further) constraints on this element Element id AdverseEvent.referenceDocument Short description AdverseEvent.referenceDocument Definition AdverseEvent.referenceDocument. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(DocumentReference) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  study	Σ C	0..1	Reference(ResearchStudy)	There are no (further) constraints on this element Element id AdverseEvent.study Short description AdverseEvent.study Definition AdverseEvent.study. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(ResearchStudy) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

• Consent

  The Consent resource documents the patient's agreement or dissent for specific immunization-related activities. This resource may include other contained resources, such as references to the patient or related persons involved in the consent process. Consent data ensures compliance with regulatory and patient-specific preferences.

  Consent	C		Consent	There are no (further) constraints on this element Element id Consent Short description A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time Definition A record of a healthcare consumer’s choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time. Comments Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives. Data type Consent Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() ppc-4: IF Scope=adr, there must be a patient patient.exists() or scope.coding.where(system='something' and code='adr').exists().not() ppc-5: IF Scope=treatment, there must be a patient patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not() ppc-2: IF Scope=privacy, there must be a patient patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not() ppc-3: IF Scope=research, there must be a patient patient.exists() or scope.coding.where(system='something' and code='research').exists().not() ppc-1: Either a Policy or PolicyRule policy.exists() or policyRule.exists() Mappings rim: Entity. Role, or Act workflow: Event v2: CON rim: FinancialConsent
  id	Σ	1..1	id	Element id Consent.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments See Mappings Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a source-PIR: CONSENT.CONSENT_DIRECTIVE.CONSENT_DIRECTIVE_ID
  meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Consent.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  id		0..1	string	There are no (further) constraints on this element Element id Consent.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  versionId	Σ	0..1	id	Element id Consent.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments Apply "2025.01.1". This indicates the FHIR Specs as of year 2025 Jan. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastUpdated	Σ	0..1	instant	Element id Consent.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments Updated: Relax the previously crossed-out elements. Data type instant Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  source	Σ	0..1	uri	There are no (further) constraints on this element Element id Consent.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  profile	Σ	1..1	canonical(StructureDefinition)	Element id Consent.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments Apply "http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Consent" Data type canonical(StructureDefinition) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  security	Σ	0..1	CodingBinding	There are no (further) constraints on this element Element id Consent.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  tag	Σ	0..1	Coding	There are no (further) constraints on this element Element id Consent.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Consent.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..1	codeBinding	There are no (further) constraints on this element Element id Consent.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Binding extensions MaxValueSet AllLanguages Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..1	Narrative	There are no (further) constraints on this element Element id Consent.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		1..*	PractitionerConsentGivenTo, RelatedPerson	Element id Consent.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type PractitionerConsentGivenTo, RelatedPerson Mappings rim: Entity. Role, or Act rim: N/A
  extension	C	2..*	Extension	There are no (further) constraints on this element Element id Consent.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  consentExtension	C	0..*	Extension(Complex)	Element id Consent.extension:consentExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Complex) Extension URL ConsentExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  id		0..1	string	There are no (further) constraints on this element Element id Consent.extension:consentExtension.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	3..*	Extension	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  PIRconsentDirectiveCategory	C	1..1	Extension	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:PIRconsentDirectiveCategory Short description PIR Consent Directive Cateogry Alternate names extensions, user content Definition PIR Consent Directive Cateogry Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:PIRconsentDirectiveCategory.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..0	Extension	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:PIRconsentDirectiveCategory.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:PIRconsentDirectiveCategory.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value PIRconsentDirectiveCategory Mappings rim: N/A
  value[x]		0..1		There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:PIRconsentDirectiveCategory.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Comments See Mappings Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: CONSENT.CONSENT_DIRECTIVE_TYPE.CATEGORY_CNCPT_ID
  valueString			string	There are no (further) constraints on this element Data type string
  PIRconsentDirectiveSubCategory	C	1..1	Extension	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:PIRconsentDirectiveSubCategory Short description PIR Consent Directive Sub-Category Alternate names extensions, user content Definition PIR Consent Directive Sub-Category Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:PIRconsentDirectiveSubCategory.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..0	Extension	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:PIRconsentDirectiveSubCategory.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:PIRconsentDirectiveSubCategory.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value PIRconsentDirectiveSubCategory Mappings rim: N/A
  value[x]		0..1		There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:PIRconsentDirectiveSubCategory.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Comments See Mappings Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: CONSENT.CONSENT_DIRECTIVE_TYPE.SUB_CATEGORY_CNCPT_ID
  valueString			string	There are no (further) constraints on this element Data type string
  PIRconsentDirectiveType	C	1..1	Extension	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:PIRconsentDirectiveType Short description PIR Consent Directive Type Alternate names extensions, user content Definition PIR Consent Directive Type Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:PIRconsentDirectiveType.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..0	Extension	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:PIRconsentDirectiveType.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:PIRconsentDirectiveType.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value PIRconsentDirectiveType Mappings rim: N/A
  value[x]		0..1		There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:PIRconsentDirectiveType.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Comments See Mappings Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: CONSENT.CONSENT_DIRECTIVE_TYPE.CONSENT_DIRECTIVE_TYPE_NAME
  valueString			string	There are no (further) constraints on this element Data type string
  consentDirectiveDoses	C	0..1	Extension	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveDoses Short description Consent for No. of Doses Alternate names extensions, user content Definition Consent for No. of Doses Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveDoses.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..0	Extension	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveDoses.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveDoses.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value consentDirectiveDoses Mappings rim: N/A
  value[x]		0..1		There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveDoses.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Comments See Mappings Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: CONSENT.CONSENT_DIRECTIVE.DOSAGE
  valueString			string	There are no (further) constraints on this element Data type string
  consentDirectiveForm	C	0..1	Extension	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveForm Short description PIR Directive Form of Consent Alternate names extensions, user content Definition PIR Directive Form of Consent Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveForm.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..0	Extension	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveForm.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveForm.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value consentDirectiveForm Mappings rim: N/A
  value[x]		0..1		There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveForm.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Comments In Person | Telephone | Written. See Mappings Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: CONSENT.CONSENT_DIRECTIVE.CONSENT_METHOD_CODE_CNCPT_ID
  valueString			string	There are no (further) constraints on this element Data type string
  consentDirectiveComments	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveComments Short description Consent Directive Comments Alternate names extensions, user content Definition Consent Directive Comments Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveComments.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..0	Extension	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveComments.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveComments.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value consentDirectiveComments Mappings rim: N/A
  value[x]		0..1	Annotation	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveComments.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Data type Annotation Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveComments.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	2..*	Extension	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveComments.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRIdentifierExtension	C	1..1	Extension(string)	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveComments.value[x].extension:pIRIdentifierExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(string) Extension URL PIRIdentifierExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRLockSeqNumberExtension	C	1..1	Extension(integer)	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveComments.value[x].extension:pIRLockSeqNumberExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(integer) Extension URL PIRLockSeqNumberExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  author[x]	Σ	0..0		There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveComments.value[x].author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Comments Organization is used when there's no need for specific attribution as to who made the comment. Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act.participant[typeCode=AUT].role
  time	Σ	0..1	dateTime	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveComments.value[x].time Short description When the annotation was made Definition Indicates when this particular annotation was made. Comments List Comments Creation DateTime by descending order. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act.effectiveTime
  text	Σ	1..1	markdown	There are no (further) constraints on this element Element id Consent.extension:consentExtension.extension:consentDirectiveComments.value[x].text Short description The annotation - text content (as markdown) Definition The text of the annotation in markdown format. Comments See Mappings Data type markdown Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act.text source-PIR: CONSENT.CONSENT_DIRECTIVE_COMMENT.CONSENT_DIRECTIVE_COMMENT
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Consent.extension:consentExtension.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/consent-type-form-doses-comments Mappings rim: N/A
  value[x]		0..0		There are no (further) constraints on this element Element id Consent.extension:consentExtension.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  pIRIdentifierExtension	C	1..1	Extension(string)	Element id Consent.extension:pIRIdentifierExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(string) Extension URL PIRIdentifierExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRLockSeqNumberExtension	C	1..1	Extension(integer)	Element id Consent.extension:pIRLockSeqNumberExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(integer) Extension URL PIRLockSeqNumberExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	?! C	0..*	Extension	There are no (further) constraints on this element Element id Consent.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  identifier	Σ	1..1	Identifier	There are no (further) constraints on this element Element id Consent.identifier Short description Identifier for this record (external references) Definition Unique identifier for this copy of the Consent Statement. Comments This identifier identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General { "system": "urn:ietf:rfc:3986", "value": "Local eCMS identifier" } Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier workflow: Event.identifier w5: FiveWs.identifier rim: .id
  id		0..1	string	There are no (further) constraints on this element Element id Consent.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Consent.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Role.code or implied by context
  type	Σ	1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Consent.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments 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. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
  id		0..1	string	There are no (further) constraints on this element Element id Consent.identifier.type.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.identifier.type.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	0..1	Coding	There are no (further) constraints on this element Element id Consent.identifier.type.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  text	Σ	1..1	string	Element id Consent.identifier.type.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: "PANORAMACONSENTID"
  system	Σ	1..1	uri	Element id Consent.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType source-PIR: https://health.gov.bc.ca/fhir/NamingSystem/ca-bc-panorama-consent-id
  value	Σ	1..1	string	Element id Consent.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 123456 Mappings rim: n/a v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value source-PIR: CONSENT.CONSENT_DIRECTIVE.CONSENT_DIRECTIVE_ID
  period	Σ C	0..1	Period	There are no (further) constraints on this element Element id Consent.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
  assigner	Σ C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Consent.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments 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. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
  status	Σ ?!	1..1	codeBinding	Element id Consent.status Short description draft | proposed | active | rejected | inactive | entered-in-error Definition Indicates the current state of this consent. Requirements The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive. Comments Confirmed (PIR) maps to Active (FHIR). See Mappings. Data type code Binding Indicates the state of the consent. ConsentState (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Event.status w5: FiveWs.status v2: HL7 Table 0498 - Consent Status rim: .statusCode source-PIR: CONSENT.CONSENT_DIRECTIVE.DIRECTIVE_STATUS_CODE_CNCPT_ID
  scope	Σ ?!	1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Consent.scope Short description Which of the four areas this resource covers (extensible) Definition A selector of the type of consent being presented: ADR, Privacy, Treatment, Research. This list is now extensible. Comments 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. Data type CodeableConcept Binding The four anticipated uses for the Consent Resource. ConsentScopeCodes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  id		0..1	string	There are no (further) constraints on this element Element id Consent.scope.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.scope.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	1..*	Coding	There are no (further) constraints on this element Element id Consent.scope.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id Consent.scope.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.scope.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id Consent.scope.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Code Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  version	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.scope.coding.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id Consent.scope.coding.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments Apply "treatment" Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.scope.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Consent.scope.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.scope.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments Very often the text is the same as a displayName of one of the codings. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  category	Σ	1..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Consent.category Short description Classification of the consent statement - for indexing/retrieval Definition A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements. Comments 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. Data type CodeableConcept Binding A classification of the type of consents found in a consent statement. ConsentCategoryCodes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.code w5: FiveWs.class v2: HL7 Table 0497 - Consent Type rim: CNTRCT
  id		0..1	string	There are no (further) constraints on this element Element id Consent.category.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.category.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id Consent.category.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id Consent.category.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.category.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id Consent.category.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Code Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  version	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.category.coding.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id Consent.category.coding.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments Apply "59284-0" Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.category.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Consent.category.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.category.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments Very often the text is the same as a displayName of one of the codings. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  patient	Σ C	0..1	Reference(Patient)	There are no (further) constraints on this element Element id Consent.patient Short description Who the consent applies to Definition The patient/healthcare consumer to whom this consent applies. Comments Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person. Data type Reference(Patient) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.subject w5: FiveWs.subject[x] rim: Role w5: FiveWs.subject
  id		0..1	string	There are no (further) constraints on this element Element id Consent.patient.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.patient.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	1..1	string	Element id Consent.patient.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: fullURL + "Patient/" + (Patient ID)
  type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id Consent.patient.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Consent.patient.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.patient.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  dateTime	Σ	0..1	dateTime	There are no (further) constraints on this element Element id Consent.dateTime Short description When this Consent was created or indexed Definition When this Consent was issued / created / indexed. Comments This is not the time of the original consent, but the time that this statement was made or derived. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Event.occurrence[x] w5: FiveWs.recorded v2: Field 13/ Consent Decision Date rim: FinancialConsent effectiveTime
  performer	Σ C	0..1	Reference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)	There are no (further) constraints on this element Element id Consent.performer Short description Who is agreeing to the policy and rules Alternate names consentor Definition Either the Grantor, which is the entity responsible for granting the rights listed in a Consent Directive or the Grantee, which is the entity responsible for complying with the Consent Directive, including any obligations or limitations on authorizations and enforcement of prohibitions. Comments Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian. Data type Reference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.performer w5: FiveWs.actor v2: Field 24/ ConsenterID
  id		0..1	string	There are no (further) constraints on this element Element id Consent.performer.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.performer.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	1..1	string	Element id Consent.performer.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: "#RelatedPerson"+(CONSENT.CONSENT_DIRECTIVE.CONSENT_DIRECTIVE_ID)"
  type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id Consent.performer.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Consent.performer.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.performer.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  organization	Σ C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Consent.organization Short description Custodian of the consent Alternate names custodian Definition The organization that manages the consent, and the framework within which it is executed. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.performer w5: FiveWs.witness
  source[x]	Σ	0..1		There are no (further) constraints on this element Element id Consent.source[x] Short description Source from which this consent is taken Definition The source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document. Comments The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id. Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Field 19 Informational Material Supplied Indicator
  sourceAttachment			Attachment	There are no (further) constraints on this element Data type Attachment
  sourceReference			Reference(Consent | Contract | DocumentReference | QuestionnaireResponse)	There are no (further) constraints on this element Data type Reference(Consent | Contract | DocumentReference | QuestionnaireResponse)
  policy		0..1	BackboneElement	There are no (further) constraints on this element Element id Consent.policy Short description Policies covered by this consent Definition The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Consent.policy.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.policy.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Consent.policy.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  authority	C	0..1	uri	There are no (further) constraints on this element Element id Consent.policy.authority Short description Enforcement source for policy Definition Entity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ppc-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  uri	C	0..1	uri	There are no (further) constraints on this element Element id Consent.policy.uri Short description Specific policy covered by this consent Definition The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. Comments This element is for discoverability / documentation and does not modify or qualify the policy rules. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ppc-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  policyRule	Σ C	1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Consent.policyRule Short description Regulation that this consents to Definition A reference to the specific base computable regulation or policy. Requirements Might be a unique identifier of a policy set in XACML, or other rules engine. Comments If the policyRule is absent, computable consent would need to be constructed from the elements of the Consent resource. Data type CodeableConcept Binding Regulatory policy examples. ConsentPolicyRuleCodes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ppc-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  id		0..1	string	There are no (further) constraints on this element Element id Consent.policyRule.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.policyRule.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	1..*	Coding	There are no (further) constraints on this element Element id Consent.policyRule.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id Consent.policyRule.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.policyRule.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id Consent.policyRule.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Code Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  version	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.policyRule.coding.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id Consent.policyRule.coding.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments Apply "cric" (Common Rule Informed Consent). Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.policyRule.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Consent.policyRule.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.policyRule.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments Very often the text is the same as a displayName of one of the codings. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  verification	Σ	0..1	BackboneElement	There are no (further) constraints on this element Element id Consent.verification Short description Consent Verified by patient or family Definition Whether a treatment instruction (e.g. artificial respiration yes or no) was verified with the patient, his/her family or another authorized person. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Consent.verification.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.verification.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Consent.verification.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  verified	Σ	1..1	boolean	There are no (further) constraints on this element Element id Consent.verification.verified Short description Has been verified Definition Has the instruction been verified. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  verifiedWith	C	0..1	Reference(Patient | RelatedPerson)	There are no (further) constraints on this element Element id Consent.verification.verifiedWith Short description Person who verified Definition Who verified the instruction (Patient, Relative or other Authorized Person). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Patient | RelatedPerson) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  verificationDate		0..1	dateTime	There are no (further) constraints on this element Element id Consent.verification.verificationDate Short description When consent verified Definition Date verification was collected. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  provision	Σ	1..1	BackboneElement	There are no (further) constraints on this element Element id Consent.provision Short description Constraints to the base Consent.policyRule Definition An exception to the base policy of this consent. An exception can be an addition or removal of access permissions. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Consent.provision.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.provision.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Consent.provision.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  type	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Consent.provision.type Short description deny | permit Definition Action to take - permit or deny - when the rule conditions are met. Not permitted in root rule, required in all nested rules. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding How a rule statement is applied, such as adding additional consent or removing consent. ConsentProvisionType (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  period	Σ C	1..1	Period	There are no (further) constraints on this element Element id Consent.provision.period Short description Timeframe for this rule Definition The timeframe in this rule is valid. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  id		0..1	string	There are no (further) constraints on this element Element id Consent.provision.period.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.provision.period.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  start	Σ C	1..1	dateTime	Element id Consent.provision.period.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments See Mappings. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1, per-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: DR.1 rim: ./low source-PIR: CONSENT.CONSENT_DIRECTIVE.EFFECT_FROM_DATE
  end	Σ C	0..1	dateTime	Element id Consent.provision.period.end Short description End time with inclusive boundary, if not ongoing Definition The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments See Mappings Meaning when missing If the end of the period is missing, it means that the period is ongoing Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1, per-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: DR.2 rim: ./high source-PIR: CONSENT.CONSENT_DIRECTIVE.EFFECT_TO_DATE
  actor		0..*	BackboneElement	There are no (further) constraints on this element Element id Consent.provision.actor Short description Who|what controlled by this rule (or group, by role) Definition Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Meaning when missing There is no specific actor associated with the exception Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  id		0..1	string	There are no (further) constraints on this element Element id Consent.provision.actor.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.provision.actor.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Consent.provision.actor.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  role		1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Consent.provision.actor.role Short description How the actor is involved Definition How the individual is involved in the resources content that is described in the exception. Comments 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. Data type CodeableConcept Binding How an actor is involved in the consent considerations. SecurityRoleType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  id		0..1	string	There are no (further) constraints on this element Element id Consent.provision.actor.role.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.provision.actor.role.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	1..*	Coding	There are no (further) constraints on this element Element id Consent.provision.actor.role.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id Consent.provision.actor.role.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.provision.actor.role.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	There are no (further) constraints on this element Element id Consent.provision.actor.role.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 reference to some definition that establishes the system clearly and unambiguously. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  version	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.provision.actor.role.coding.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id Consent.provision.actor.role.coding.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments Apply "CONSENTER" Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.provision.actor.role.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Consent.provision.actor.role.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.provision.actor.role.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments Very often the text is the same as a displayName of one of the codings. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  reference	C	1..1	Reference(CareTeam | Device | Group | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)	There are no (further) constraints on this element Element id Consent.provision.actor.reference Short description Resource for the actor (or group, by role) Definition The resource that identifies the actor. To identify actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareTeam | Device | Group | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  id		0..1	string	There are no (further) constraints on this element Element id Consent.provision.actor.reference.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.provision.actor.reference.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	1..1	string	Element id Consent.provision.actor.reference.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: "#PractitionerConsentGivenTo"+(CONSENT.CONSENT_DIRECTIVE.CONSENT_DIRECTIVE_ID)"
  type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id Consent.provision.actor.reference.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Consent.provision.actor.reference.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.provision.actor.reference.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  action	Σ	1..1	CodeableConcept	Element id Consent.provision.action Short description Consent or Refusal Definition Consent or Refusal Comments Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'. Meaning when missing all actions Data type CodeableConcept Binding Detailed codes for the consent action. ConsentActionCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  id		0..1	string	There are no (further) constraints on this element Element id Consent.provision.action.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.provision.action.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	1..*	Coding	Element id Consent.provision.action.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Slicing Unordered, Open, by code(Value) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  sliceConsentInstruction	Σ	1..1	Coding	There are no (further) constraints on this element Element id Consent.provision.action.coding:sliceConsentInstruction Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id Consent.provision.action.coding:sliceConsentInstruction.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.provision.action.coding:sliceConsentInstruction.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id Consent.provision.action.coding:sliceConsentInstruction.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Code Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  version	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.provision.action.coding:sliceConsentInstruction.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id Consent.provision.action.coding:sliceConsentInstruction.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments G | R. Refer to IMMS codeset spreadsheet: Consent - Instruction. See Mappings. Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code source-PIR: CONSENT.CONSENT_DIRECTIVE.CONSENT_VALUE_CODED_CNCPT_ID
  display	Σ	1..1	string	Element id Consent.provision.action.coding:sliceConsentInstruction.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Grant | Refuse Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Consent.provision.action.coding:sliceConsentInstruction.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  sliceConsentRefusalReaason	Σ	1..1	Coding	There are no (further) constraints on this element Element id Consent.provision.action.coding:sliceConsentRefusalReaason Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id Consent.provision.action.coding:sliceConsentRefusalReaason.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.provision.action.coding:sliceConsentRefusalReaason.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id Consent.provision.action.coding:sliceConsentRefusalReaason.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Code Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  version	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.provision.action.coding:sliceConsentRefusalReaason.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id Consent.provision.action.coding:sliceConsentRefusalReaason.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments Refer to IMMS codeset spreadsheet: Consent - Reason. See Mappings Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code source-PIR: CONSENT.CONSENT_DIRECTIVE.REFUSAL_REASON_CODE_CNCPT_ID
  display	Σ	1..1	string	Element id Consent.provision.action.coding:sliceConsentRefusalReaason.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Refer to IMMS codeset spreadsheet: Consent - Reason Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Consent.provision.action.coding:sliceConsentRefusalReaason.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	Element id Consent.provision.action.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments Mandatory if Reason for Refusal = "O"ther. See Mappings. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: CONSENT.CONSENT_DIRECTIVE.REFUSAL_REASON_OTHER
  securityLabel	Σ	0..1	CodingBinding	There are no (further) constraints on this element Element id Consent.provision.securityLabel Short description Security Labels that define affected resources Definition A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception. Comments If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  purpose	Σ	0..1	CodingBinding	There are no (further) constraints on this element Element id Consent.provision.purpose Short description Context of activities covered by this rule Definition The context of the activities a user is taking - why the user is accessing the data - that are controlled by this rule. Comments When the purpose of use tag is on the data, access request purpose of use shall not conflict. Data type Coding Binding What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels. v3.PurposeOfUse (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  class	Σ	0..1	CodingBinding	There are no (further) constraints on this element Element id Consent.provision.class Short description e.g. Resource Type, Profile, CDA, etc. Definition The class of information covered by this rule. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to. Comments Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere. Data type Coding Binding The class (type) of information a consent rule covers. ConsentContentClass (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  code	Σ	1..*	CodeableConcept	There are no (further) constraints on this element Element id Consent.provision.code Short description e.g. LOINC or SNOMED CT code, etc. in the content Definition If this code is found in an instance, then the rule applies. Comments Typical use of this is a Document code with class = CDA. Data type CodeableConcept Binding If this code is found in an instance, then the exception applies. ConsentContentCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  id		0..1	string	There are no (further) constraints on this element Element id Consent.provision.code.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.provision.code.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	1..*	Coding	There are no (further) constraints on this element Element id Consent.provision.code.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id Consent.provision.code.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.provision.code.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id Consent.provision.code.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem code-NVC: https://nvc-cnv.canada.ca code-SNOMED: http://snomed.info/sct code-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code
  version	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.provision.code.coding.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id Consent.provision.code.coding.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments Enter Vaccine code for both consent and Consent Refussal. See Mappings. Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code source-PIR: CONSENT.CONSENT_DIRECTIVE.DIRECTIVE_ANTIGEN_ID
  display	Σ	1..1	string	Element id Consent.provision.code.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Enter Vaccine Name for Consent or Consent Refussal Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Consent.provision.code.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.provision.code.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments Very often the text is the same as a displayName of one of the codings. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  dataPeriod	Σ C	0..1	Period	There are no (further) constraints on this element Element id Consent.provision.dataPeriod Short description Timeframe for data controlled by this rule Definition Clinical or Operational Relevant period of time that bounds the data controlled by this rule. Comments This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  data	Σ	0..1	BackboneElement	There are no (further) constraints on this element Element id Consent.provision.data Short description Data controlled by this rule Definition The resources controlled by this rule if specific resources are referenced. Meaning when missing all data Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: Role
  id		0..1	string	There are no (further) constraints on this element Element id Consent.provision.data.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id Consent.provision.data.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Consent.provision.data.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  meaning	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Consent.provision.data.meaning Short description instance | related | dependents | authoredby Definition How the resource reference is interpreted when testing consent restrictions. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding How a resource reference is interpreted when testing consent restrictions. ConsentDataMeaning (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  reference	Σ C	1..1	Reference(Resource)	There are no (further) constraints on this element Element id Consent.provision.data.reference Short description The actual data reference Definition A reference to a specific resource that defines which resources are covered by this consent. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Resource) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  provision		0..1	see (provision)	There are no (further) constraints on this element Element id Consent.provision.provision Short description Nested Exception Rules Definition Rules which provide exceptions to the base rule or subrules.

• ImmunizationRecommendation

  The ImmunizationRecommendation resource provides guidance on future immunizations, based on the patient’s current immunization history. It helps inform the healthcare provider or system about what immunizations may be due or overdue, providing a forecast for continued vaccination care.

  ImmunizationRecommendation	C		ImmunizationRecommendation	Element id ImmunizationRecommendation Short description FHIR resource applies for PIR Vaccine Forecast Definition FHIR resource applies for PIR Vaccine Forecast Data type ImmunizationRecommendation Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act workflow: Request v2: VXU_V04 rim: SubstanceAdministration[moodCode=RMD]
  id	Σ	1..1	id	Element id ImmunizationRecommendation.id Short description PIR Internal Vaccination Forecast ID Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments See Mappings Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a source-PIR: H33_VACCINATION_FORECAST.VACCINATION_FORECAST_ID source-PHSL: forecastId
  meta	Σ	1..1	Meta	There are no (further) constraints on this element Element id ImmunizationRecommendation.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  id		0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  versionId	Σ	0..1	id	Element id ImmunizationRecommendation.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments Apply "2025.01.1". This indicates the FHIR Specs as of year 2025 Jan. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastUpdated	Σ	0..1	instant	Element id ImmunizationRecommendation.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments Updated: Relax the previously crossed-out elements. Data type instant Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  source	Σ	0..1	uri	There are no (further) constraints on this element Element id ImmunizationRecommendation.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  profile	Σ	1..1	canonical(StructureDefinition)	Element id ImmunizationRecommendation.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments Apply "http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/ImmunizationRecommendation" Data type canonical(StructureDefinition) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  security	Σ	0..1	CodingBinding	There are no (further) constraints on this element Element id ImmunizationRecommendation.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  tag	Σ	0..1	Coding	There are no (further) constraints on this element Element id ImmunizationRecommendation.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id ImmunizationRecommendation.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..1	codeBinding	There are no (further) constraints on this element Element id ImmunizationRecommendation.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Binding extensions MaxValueSet AllLanguages Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..1	Narrative	There are no (further) constraints on this element Element id ImmunizationRecommendation.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		0..1	Resource	There are no (further) constraints on this element Element id ImmunizationRecommendation.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
  extension	C	2..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRIdentifierExtension	C	1..1	Extension(string)	Element id ImmunizationRecommendation.extension:pIRIdentifierExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(string) Extension URL PIRIdentifierExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRLockSeqNumberExtension	C	1..1	Extension(integer)	Element id ImmunizationRecommendation.extension:pIRLockSeqNumberExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(integer) Extension URL PIRLockSeqNumberExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	?! C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  identifier	Σ	1..1	Identifier	Element id ImmunizationRecommendation.identifier Short description PIR Internal Vaccination Forecast ID Definition PIR Internal Vaccination Forecast ID Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier workflow: Request.identifier w5: FiveWs.identifier rim: .id
  id		0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id ImmunizationRecommendation.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Role.code or implied by context
  type	Σ	1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id ImmunizationRecommendation.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments 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. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
  id		0..0	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.identifier.type.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.identifier.type.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	0..0	Coding	There are no (further) constraints on this element Element id ImmunizationRecommendation.identifier.type.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  text	Σ	1..1	string	Element id ImmunizationRecommendation.identifier.type.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: PANORAMAIMMZFORECASTID
  system	Σ	1..1	uri	Element id ImmunizationRecommendation.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType source-PIR: https://health.gov.bc.ca/fhir/NamingSystem/ca-bc-panorama-immunization-forecaster-id
  value	Σ	1..1	string	Element id ImmunizationRecommendation.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 123456 Mappings rim: n/a v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value source-PIR: H33_VACCINATION_FORECAST.VACCINATION_FORECAST_ID source-PHSL: forecastId
  period	Σ C	0..1	Period	There are no (further) constraints on this element Element id ImmunizationRecommendation.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
  assigner	Σ C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id ImmunizationRecommendation.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments 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. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
  patient	Σ C	1..1	Reference(Patient)	There are no (further) constraints on this element Element id ImmunizationRecommendation.patient Short description Who this profile is for Definition The patient the recommendation(s) are for. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Patient) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.subject w5: FiveWs.subject[x] v2: PID-3 rim: .partipication[typeCode=SUBJ].role w5: FiveWs.subject
  id		0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.patient.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.patient.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	1..1	string	Element id ImmunizationRecommendation.patient.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: fullURL of Panorama + "Patient" + PIR Client ID
  type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id ImmunizationRecommendation.patient.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id ImmunizationRecommendation.patient.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.patient.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  date	Σ	1..1	dateTime	Element id ImmunizationRecommendation.date Short description Date Forecast Status Calculated as of Definition Date Forecast Status Calculated as of Comments See Mappings Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.authoredOn v2: OBX-15 rim: .partipication[typeCode=AUTH].time source-PIR: PIR H33_VACCINATION_FORECAST.CREATED_ON
  authority	C	1..1	Reference(Organization)	Element id ImmunizationRecommendation.authority Short description Organization runs the vaccination forecast Definition Organization runs the vaccination forecast Comments For IDS, Panorama is the organization that runs the vaccination forecast. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: OBX-5 : OBX-3 = 59779-9 rim: .participation[typeCode=AUT]
  id		0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.authority.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.authority.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	1..1	string	Element id ImmunizationRecommendation.authority.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: fullURL of Panorama + "Organization" + PIR Organization ID
  type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id ImmunizationRecommendation.authority.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id ImmunizationRecommendation.authority.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.authority.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  recommendation	Σ C	1..*	BackboneElement	Element id ImmunizationRecommendation.recommendation Short description Vaccine forecasted to be administered. Definition Vaccine forecasted to be administered with different date criterion + targeted disease(s). Comments 1st instance is the Agent + Antigen(s) + Agent Dates + no Disease, subsequent instances are Antigen + Disease + Disease Dates Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) imr-1: One of vaccineCode or targetDisease SHALL be present vaccineCode.exists() or targetDisease.exists() Mappings rim: n/a rim: .outboundRelationship[typeCode='COMP'].target[classCode=SBADM, moodCode=RMD]
  id		0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  forecastedDoseVolumeExtension	C	0..1	Extension(Quantity)	Element id ImmunizationRecommendation.recommendation.extension:forecastedDoseVolumeExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Quantity) Extension URL ForecastedDoseVolumeExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  forecastMoreInfoEDSExtension	C	0..1	Extension(CodeableConcept)	Element id ImmunizationRecommendation.recommendation.extension:forecastMoreInfoEDSExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Whether the forecasted agent/antigen is extra dose safe (EDS). Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(CodeableConcept) Extension URL ForecastMoreInfoEDSExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  forecastMoreInfoLOAExtension	C	0..1	Extension(CodeableConcept)	Element id ImmunizationRecommendation.recommendation.extension:forecastMoreInfoLOAExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Whether the forecasted agent/antigen is left over antigen (LOA). Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(CodeableConcept) Extension URL ForecastMoreInfoLOAExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  vaccineCode	Σ	1..*	CodeableConcept	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode Short description Vaccine or vaccine group recommendation applies to Definition Vaccine(s) or vaccine group that pertain to the recommendation. Comments 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. Data type CodeableConcept Binding The type of vaccine administered. VaccineAdministeredValueSet (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.code v2: OBX-5 : OBX-3 = ( 30956-7 | 38890-0 ) rim: .partipication[typeCode=CSM].role[classCode=ADMM].code
  id		0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	1..1	Coding	Element id ImmunizationRecommendation.recommendation.vaccineCode.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Slicing Unordered, Open, by code(Value) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  (All Slices)				The requirements in this element apply to all slices
  id		0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	0..1	uri	Element id ImmunizationRecommendation.recommendation.vaccineCode.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  version	Σ	0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	0..1	code	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  AgentNVC	Σ	1..1	Coding	Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AgentNVC Short description Agent in CVC code Definition Agent in CVC code Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AgentNVC.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AgentNVC.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AgentNVC.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem Code-SNOMED: http://snomed.info/sct Code-NVC: https://nvc-cnv.canada.ca
  version	Σ	0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AgentNVC.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AgentNVC.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments See Mappings Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code source-PIR: PIR H33_VACCINATION_FORECAST.FAMILY_CODE source-PHSL: forecastIImmsAgentCode
  display	Σ	1..1	string	Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AgentNVC.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName source-PIR: REPORTNG.GET_ITERM_DESC(H33_VACCINATION_FORECAST.FAMILY_CODE) source-PHSL: forecastImmsAgentDescription
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AgentNVC.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  AgentPIR	Σ	0..1	Coding	Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AgentPIR Short description Agent in PIR code Definition Agent in PIR code Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Agent in PIR code. See Mappings. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AgentPIR.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AgentPIR.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AgentPIR.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem code-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code
  version	Σ	0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AgentPIR.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AgentPIR.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	1..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AgentPIR.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AgentPIR.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  AntigenNVC	Σ	0..1	Coding	Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AntigenNVC Short description Antigen in NVC code Definition Antigen in NVC code Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AntigenNVC.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AntigenNVC.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AntigenNVC.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem Code-SNOMED: http://snomed.info/sct Code-NVC: https://nvc-cnv.canada.ca
  version	Σ	0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AntigenNVC.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AntigenNVC.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments See Mappings Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code source-PIR: FORECAST_ANTIGEN.ASIIS_VACC_CODE source-PHSL: Antigen.forecastImmsAntigenCode
  display	Σ	1..1	string	Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AntigenNVC.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName source-PIR: REPORTNG.GET_ITERM_DESC(FORECAST_ANTIGEN.ASIIS_VACC_CODE) source-PHSL: Antigen.forecastImmsAntigenDescription
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AntigenNVC.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  AntigenPIR	Σ	0..1	Coding	Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AntigenPIR Short description Antigen in PIR code Definition Antigen in PIR code Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AntigenPIR.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AntigenPIR.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AntigenPIR.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments Anitgen in PIR code. See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem code-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code
  version	Σ	0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AntigenPIR.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AntigenPIR.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	1..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AntigenPIR.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode.coding:AntigenPIR.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	Element id ImmunizationRecommendation.recommendation.vaccineCode.text Short description Trade Name Definition Trade Name Requirements 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. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: H33_VACCINATION_FORECAST.TRADE source-PHSL: trade
  targetDisease	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.targetDisease Short description Disease to be immunized against Definition The targeted disease for the recommendation. Comments 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. Data type CodeableConcept Binding The disease that the recommended vaccination targets. ImmunizationRecommendationTargetDiseaseCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: OBX-5 : OBX-3 = ( 30956-7 | 38890-0 ) rim: .partipication[typeCode=CSM].role[classCode=ADMM].code
  id		0..0	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.targetDisease.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.targetDisease.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	1..*	Coding	Element id ImmunizationRecommendation.recommendation.targetDisease.coding Short description 1st instance Disease in CVC code, 2nd instance Disease in PIR code Definition 1st instance Disease in CVC code, 2nd instance Disease in PIR code Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments One Agent can have > 1 antigen, and one agent can have > 1 disease Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..0	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.targetDisease.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.targetDisease.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id ImmunizationRecommendation.recommendation.targetDisease.coding.system Short description 1st instance: Disease in NVC code. 2nd instance: Disease in PIR code. Definition 1st instance: Disease in NVC code. 2nd instance: Disease in PIR code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 1st instance: Disease in NVC code. 2nd instance: Disease in PIR code. See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem code-NVC: https://nvc-cnv.canada.ca code-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code
  version	Σ	0..0	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.targetDisease.coding.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id ImmunizationRecommendation.recommendation.targetDisease.coding.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments 1st instance Disease in CVC code, 2nd instance Disease in PIR code. See Mappings Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code source-PIR-disease: BCYREPORTNG.RBCY_FN_GET_CONCEPT_CODE(DISEASE.DISEASE_CODE_CNCPT_ID) source-PHSL: Antigen.immunizationDiseaseCode
  display	Σ	1..1	string	Element id ImmunizationRecommendation.recommendation.targetDisease.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName source-PIR: REPORTNG.GET_ITERM_DESC(DISEASE.DISEASE_CODE_CNCPT_ID) source-PHSL: Antigen.immunizationDiseaseDescription
  userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.targetDisease.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..0	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.targetDisease.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments Very often the text is the same as a displayName of one of the codings. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  contraindicatedVaccineCode	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.contraindicatedVaccineCode Short description Vaccine which is contraindicated to fulfill the recommendation Definition Vaccine(s) which should not be used to fulfill the recommendation. Comments 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. Data type CodeableConcept Binding The type of vaccine administered. VaccineAdministeredValueSet (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  forecastStatus	Σ ?!	1..1	CodeableConcept	Element id ImmunizationRecommendation.recommendation.forecastStatus Short description Vaccination forecast status Definition Indicates the patient status with respect to the path to immunity for the target disease. Comments 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. Data type CodeableConcept Binding The patient's status with respect to a vaccination protocol. ImmunizationRecommendationStatusCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: OBX-5 : OBX-3 = 59783-1 rim: .inboundRelationship[typeCode=SUBJ] .source[classCode=OBS, moodCode=EVN, code="Immunization Forecast Status"].value
  id		0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.forecastStatus.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.forecastStatus.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	1..1	Coding	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.forecastStatus.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..0	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.forecastStatus.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.forecastStatus.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id ImmunizationRecommendation.recommendation.forecastStatus.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem source-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code
  version	Σ	0..0	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.forecastStatus.coding.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id ImmunizationRecommendation.recommendation.forecastStatus.coding.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments See Mappings Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code source-PIR-calculated-overdue: OVERDUE source-PIR-calculated-due: DUE source-PIR-calculated-eligible: ELIGIBLE source-PIR-calculated-upToDate: UPTODATE source-PIR-calculated-notForecasted: NOTFORECASTED source-PIR-calculated-unknown: UNKNOWN source-PHSL: forecastStatus
  display	Σ	0..1	string	Element id ImmunizationRecommendation.recommendation.forecastStatus.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName source-PIR-calculated-overdue: Overdue source-PIR-calculated-due: Due
  userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.forecastStatus.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.forecastStatus.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments Very often the text is the same as a displayName of one of the codings. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  forecastReason	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.forecastReason Short description Vaccine administration status reason Definition The reason for the assigned forecast status. Comments 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. Data type CodeableConcept Binding The reason for the patient's status with respect to a vaccination protocol. ImmunizationRecommendationReasonCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: OBX-5 : OBX-3 = 30982-3 rim: N/A
  dateCriterion		1..*	BackboneElement	Element id ImmunizationRecommendation.recommendation.dateCriterion Short description Dates governing proposed immunization Definition Vaccination date recommendations. For example, earliest date to administer, latest date to administer, etc. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.occurrence[x] v2: OBX-3: 30980-7 = Next dose recommended, 59777-3 = Latest next dose should be given, 59778-1 = Dose is overdue rim: .outboundRelationship[typeCode='LIMIT'].target[classCode=OBS, moodCode=EVN, isCriterionInd=true]
  id		0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.dateCriterion.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.dateCriterion.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.dateCriterion.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  code		1..1	CodeableConcept	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.dateCriterion.code Short description Type of date Definition Date classification of recommendation. For example, earliest date to give, latest date to give, etc. Comments 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. Data type CodeableConcept Binding Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.). ImmunizationRecommendationDateCriterionCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: OBX-3 rim: .code
  id		0..0	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.dateCriterion.code.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.dateCriterion.code.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	1..1	Coding	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.dateCriterion.code.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..0	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.dateCriterion.code.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.dateCriterion.code.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id ImmunizationRecommendation.recommendation.dateCriterion.code.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem source-PIR: http://loinc.org
  version	Σ	0..0	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.dateCriterion.code.coding.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id ImmunizationRecommendation.recommendation.dateCriterion.code.coding.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments See Mappings Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code source-PIR-eligible-date: 30981-5 source-PIR-due-date: 30980-7 source-PIR-past-due-date: 59778-1 source-PIR-max-date: 59777-3 source-PHSL-agent-eligible-date: agentEligibleDate source-PHSL-agent-due-date: agentDueDate source-PHSL-agent-past-due-date: agentPastDueDate source-PHSL-agent-max-date: agentMaxDate source-PHSL-antigen.disease-eligible-date: Antigen.diseaseEligibleDate source-PHSL-antigen-disease-due-date: Antigen.diseaseDueDate
  display	Σ	1..1	string	Element id ImmunizationRecommendation.recommendation.dateCriterion.code.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName source-PIR-eligible-date: Earliest date to give source-PIR-due-date: Date vaccine due source-PIR-past-due-date: Date when overdue for immunization source-PIR-max-date: Latest date to give immunization
  userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.dateCriterion.code.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	1..1	string	Element id ImmunizationRecommendation.recommendation.dateCriterion.code.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR-agent-eligible-date: Forecast by Agent Eligible Date source-PIR-agent-due-date: Forecast by Agent Due Date source-PIR-agent-past-due-date: Forecast by Agent Past Due Date source-PIR-agent-max-date: Forecast by Agent Max Date source-PIR-disease-eligible-date: Forecast by Disease Eligible Date source-PIR-disease-due-date: Forecast by Disease Due Date
  value		1..1	dateTime	Element id ImmunizationRecommendation.recommendation.dateCriterion.value Short description Recommended date Definition The date whose meaning is specified by dateCriterion.code. Comments See Mappings Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: OBX-5 rim: .value Date-PastDue: PAST_DUE_DATE in REPORTNG.H33_VACCINATION_FORECAST Date-MaxDate: MAXIMUM_DATE in REPORTNG.H33_VACCINATION_FORECAST Date-Eligible: MINIMUM_DATE in REPORTNG.H33_VACCINATION_FORECAST Date-Due: DUE_DATE in REPORTNG.H33_VACCINATION_FORECAST Date-DiseaseEligibleDate: H33_VACCINATION_FORECAST.MINIMUM_DATE Date-DiseaseDueDate: H33_VACCINATION_FORECAST.DUE_DATE
  description		1..1	string	Element id ImmunizationRecommendation.recommendation.description Short description Forecast Agent + Antigen combined description Definition Forecast Agent + Antigen combined description Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: OBX-5 : OBX-3 = 30956-7 rim: .text source-PIR: BCYREPORTNG.RBCY_T_AGENT_ANTIGENS_COMBINED.ANTIGENS source-PHSL: Antigen.forecastAgentAntigenCombinedDescription
  series		0..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.series Short description Name of vaccination series Definition One possible path to achieve presumed immunity against a disease - within the context of an authority. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: RXA-5-administered code rim: .title
  doseNumber[x]	Σ	0..1		Element id ImmunizationRecommendation.recommendation.doseNumber[x] Short description Recommended dose number within series Definition Nominal position of the recommended dose in a series (e.g. dose 2 is the next recommended dose). Comments See Mappings Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: OBX-5 : OBX-3 = 30973-2 rim: .inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=INT]].sequenceNumber source-PIR: PIR h33_vaccination_forecast.Dose_Number
  doseNumberString			string	Data type string
  seriesDoses[x]		0..1		There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.seriesDoses[x] Short description Recommended number of doses for immunity Definition The recommended number of doses to achieve immunity. Comments The use of an integer is prefered if known. A string should only be used in cases where an interger is not available (such as when documenting a recurring booster dose). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: OBX-5 : OBX-3 = 59782-3 rim: .inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=DEF]].sequenceNumber
  seriesDosesPositiveInt			positiveInt	There are no (further) constraints on this element Data type positiveInt
  seriesDosesString			string	There are no (further) constraints on this element Data type string
  supportingImmunization	C	0..1	Reference(Immunization | ImmunizationEvaluation)	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.supportingImmunization Short description Past immunizations supporting recommendation Definition Immunization event history and/or evaluation that supports the status and recommendation. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Immunization | ImmunizationEvaluation) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: ? No clear way to associate in HL7 v2 or IG rim: .outboundRelationship[typeCode=RSON].target[classCode=SBADM, moodCode=EVN, code="immunization"]
  supportingPatientInformation	C	0..1	Reference(Resource)	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.supportingPatientInformation Short description Patient observations supporting recommendation Definition Patient Information that supports the status and recommendation. This includes patient observations, adverse reactions and allergy/intolerance information. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Resource) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.supportingInfo v2: OBX If OBX is associated with ( RXA : RXA-5-administered code = '998^No vaccine administered^CVX'), could contain the reason the vaccine was not administered rim: .outboundRelationship[typeCode=RSON].target[classCode=OBS, moodCode=EVN]

• RiskAssessment

  The RiskAssessment resource evaluates the potential risk factors that may affect the patient's immunization needs or outcomes. These assessments are tied to the patient's clinical history and are used to guide immunization decision-making based on identified risks.

  RiskAssessment	C		RiskAssessment	Element id RiskAssessment Short description FHIR resource applies for PIR Risk Factors Alternate names Prognosis Definition FHIR resource applies for PIR Risk Factors. Note: Only Risk Factor wtih Response = "YES" and Reason ends with '*' in PIR will be sent in IDS. Data type RiskAssessment Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act workflow: Event v2: N/A rim: Observation[classCode=OBS, moodCode=EVN, code="Risk Assessment"] openehr: OpenEHR-EHR-EVALUATION.risk.v1
  id	Σ	1..1	id	Element id RiskAssessment.id Short description PIR internal Risk Factor ID + External Risk Factor ID from source system(s) Definition PIR internal Risk Factor Identifier + External Risk Factor ID from source system(s) Comments See Mappings Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a source-PIR: RISK_FACTORS.RISK_FACTOR_ID source-PHSL: riskFactorId
  meta	Σ	1..1	Meta	There are no (further) constraints on this element Element id RiskAssessment.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  id		0..1	string	There are no (further) constraints on this element Element id RiskAssessment.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id RiskAssessment.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  versionId	Σ	0..1	id	Element id RiskAssessment.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments Apply "2025.01.1". This indicates the FHIR Specs as of year 2025 Jan Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastUpdated	Σ	0..1	instant	Element id RiskAssessment.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments Updated: Relax the previously crossed-out elements. Data type instant Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  source	Σ	0..1	uri	There are no (further) constraints on this element Element id RiskAssessment.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  profile	Σ	1..1	canonical(StructureDefinition)	Element id RiskAssessment.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments Apply "http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/RiskAssessment" Data type canonical(StructureDefinition) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  security	Σ	0..1	CodingBinding	There are no (further) constraints on this element Element id RiskAssessment.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  tag	Σ	0..1	Coding	There are no (further) constraints on this element Element id RiskAssessment.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id RiskAssessment.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..1	codeBinding	There are no (further) constraints on this element Element id RiskAssessment.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Binding extensions MaxValueSet AllLanguages Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..1	Narrative	There are no (further) constraints on this element Element id RiskAssessment.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		0..1	Resource	There are no (further) constraints on this element Element id RiskAssessment.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
  extension	C	2..*	Extension	There are no (further) constraints on this element Element id RiskAssessment.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  riskFactorStatusExtension	C	0..1	Extension(Complex)	Element id RiskAssessment.extension:riskFactorStatusExtension Short description Risk Factor Deletion Reason Alternate names extensions, user content Definition Risk Factor Deletion Reason Comments To be applied to send if Risk Factor has been end-dated in PIR and/or Risk Factor has been deleted in PIR Data type Extension(Complex) Extension URL RiskFactorStatusExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  id		0..1	string	There are no (further) constraints on this element Element id RiskAssessment.extension:riskFactorStatusExtension.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id RiskAssessment.extension:riskFactorStatusExtension.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  RFendDateReason	C	0..1	Extension	Element id RiskAssessment.extension:riskFactorStatusExtension.extension:RFendDateReason Short description Risk Factor End-Dated Reason Alternate names extensions, user content Definition Risk Factor Deleted Reason Comments To be applied to send if Risk Factor has been end-dated in PIR Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id RiskAssessment.extension:riskFactorStatusExtension.extension:RFendDateReason.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id RiskAssessment.extension:riskFactorStatusExtension.extension:RFendDateReason.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id RiskAssessment.extension:riskFactorStatusExtension.extension:RFendDateReason.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value RFendDateReason Mappings rim: N/A
  value[x]		1..1		There are no (further) constraints on this element Element id RiskAssessment.extension:riskFactorStatusExtension.extension:RFendDateReason.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  valueString			string	There are no (further) constraints on this element Data type string
  RFdeleteReason	C	0..1	Extension	Element id RiskAssessment.extension:riskFactorStatusExtension.extension:RFdeleteReason Short description Risk Factor End-Dated Reason = "Other, specify" Alternate names extensions, user content Definition Risk Factor End-Dated Reason = "Other, specify" Comments To be applied to send if Risk Factor has been deleted in PIR with reason found in PIR drop-down list or NO delete reason provided. See Mappings. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A source-PIR-nullReason: Other
  id		0..0	string	There are no (further) constraints on this element Element id RiskAssessment.extension:riskFactorStatusExtension.extension:RFdeleteReason.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id RiskAssessment.extension:riskFactorStatusExtension.extension:RFdeleteReason.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id RiskAssessment.extension:riskFactorStatusExtension.extension:RFdeleteReason.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value RFdeleteReason Mappings rim: N/A
  value[x]		1..1		There are no (further) constraints on this element Element id RiskAssessment.extension:riskFactorStatusExtension.extension:RFdeleteReason.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  valueString			string	There are no (further) constraints on this element Data type string
  RFdeleteReasonOther	C	0..1	Extension	Element id RiskAssessment.extension:riskFactorStatusExtension.extension:RFdeleteReasonOther Short description Risk Factor Deleted Reason Other, specify Alternate names extensions, user content Definition Risk Factor Deleted Reason Other, specify Comments To be applied to send if Risk Factor has been deleted in PIR with reason not found in PIR drop-down list or NO deletion reason provided. See Mappings. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A source-PIR-null: unknown
  id		0..0	string	There are no (further) constraints on this element Element id RiskAssessment.extension:riskFactorStatusExtension.extension:RFdeleteReasonOther.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id RiskAssessment.extension:riskFactorStatusExtension.extension:RFdeleteReasonOther.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id RiskAssessment.extension:riskFactorStatusExtension.extension:RFdeleteReasonOther.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value RFdeleteReasonOther Mappings rim: N/A
  value[x]		1..1		There are no (further) constraints on this element Element id RiskAssessment.extension:riskFactorStatusExtension.extension:RFdeleteReasonOther.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  valueString			string	There are no (further) constraints on this element Data type string
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id RiskAssessment.extension:riskFactorStatusExtension.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/riskFactor-status Mappings rim: N/A
  value[x]		0..0		There are no (further) constraints on this element Element id RiskAssessment.extension:riskFactorStatusExtension.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  pIRIdentifierExtension	C	1..1	Extension(string)	Element id RiskAssessment.extension:pIRIdentifierExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(string) Extension URL PIRIdentifierExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRLockSeqNumberExtension	C	1..1	Extension(integer)	Element id RiskAssessment.extension:pIRLockSeqNumberExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(integer) Extension URL PIRLockSeqNumberExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	?! C	0..*	Extension	There are no (further) constraints on this element Element id RiskAssessment.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  identifier	Σ	1..1	Identifier	Element id RiskAssessment.identifier Short description PIR internal Risk Factor ID + External Risk Factor ID Definition PIR internal Risk Factor ID and/or External Risk Factor ID sent from source system(s) Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier workflow: Event.identifier w5: FiveWs.identifier rim: .id openehr: Workflow Identifier
  id		0..1	string	There are no (further) constraints on this element Element id RiskAssessment.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id RiskAssessment.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id RiskAssessment.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Role.code or implied by context
  type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id RiskAssessment.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments 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. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
  id		0..1	string	There are no (further) constraints on this element Element id RiskAssessment.identifier.type.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id RiskAssessment.identifier.type.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	0..1	Coding	There are no (further) constraints on this element Element id RiskAssessment.identifier.type.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  text	Σ	1..1	string	Element id RiskAssessment.identifier.type.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: PANORAMARISKFACTORID
  system	Σ	1..1	uri	Element id RiskAssessment.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType source-PIR: https://health.gov.bc.ca/fhir/NamingSystem/ca-bc-panorama-risk-factor-id
  value	Σ	1..1	string	Element id RiskAssessment.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 123456 Mappings rim: n/a v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value source-PIR: RISK_FACTORS.RISK_FACTOR_ID source-PHSL: riskFactorId
  period	Σ C	0..1	Period	There are no (further) constraints on this element Element id RiskAssessment.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
  assigner	Σ C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id RiskAssessment.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments 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. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
  basedOn	C	0..1	Reference(Resource)	There are no (further) constraints on this element Element id RiskAssessment.basedOn Short description Request fulfilled by this assessment Definition A reference to the request that is fulfilled by this risk assessment. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Resource) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.basedOn
  parent	C	0..1	Reference(Resource)	There are no (further) constraints on this element Element id RiskAssessment.parent Short description Part of this occurrence Definition A reference to a resource that this risk assessment is part of, such as a Procedure. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Resource) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.partOf
  status	Σ	1..1	codeBinding	Element id RiskAssessment.status Short description PIR applies statuses : final | canceled | Definition PIR applies statuses : final | canceled | Comments See Mappings Data type code Binding The status of the risk assessment; e.g. preliminary, final, amended, etc. ObservationStatus (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Event.status w5: FiveWs.status source-PIR-final: final source-PIR-deleted: cancelled
  method	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id RiskAssessment.method Short description Evaluation mechanism Definition The algorithm, process or mechanism used to evaluate the risk. Requirements The method can influence the results of the assessment. Comments 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. Data type CodeableConcept Binding The mechanism or algorithm used to make the assessment; e.g. TIMI, PRISM, Cardiff Type 2 diabetes, etc. (unbound) (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.class rim: .methodCode
  code	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id RiskAssessment.code Short description Type of assessment Definition The type of the risk assessment performed. Comments 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. Data type CodeableConcept Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.code w5: FiveWs.what[x]
  subject	Σ C	1..1	Reference(Group | Patient)	There are no (further) constraints on this element Element id RiskAssessment.subject Short description Who/what does assessment apply to? Definition The patient or group the risk assessment applies to. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Group | Patient) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.subject w5: FiveWs.subject[x] rim: .participation[typeCode=SBJ].role openehr: Subject of Care w5: FiveWs.subject
  id		0..1	string	There are no (further) constraints on this element Element id RiskAssessment.subject.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id RiskAssessment.subject.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	1..1	string	Element id RiskAssessment.subject.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: fullURL of Panorama + "Patient" + PIR Client ID
  type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id RiskAssessment.subject.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id RiskAssessment.subject.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..1	string	There are no (further) constraints on this element Element id RiskAssessment.subject.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  encounter	Σ C	0..1	Reference(Encounter)	There are no (further) constraints on this element Element id RiskAssessment.encounter Short description Where was assessment performed? Definition The encounter where the assessment was performed. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Encounter) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.encounter w5: FiveWs.context rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
  occurrence[x]	Σ	1..1	dateTime	Element id RiskAssessment.occurrence[x] Short description Risk Factor Date Reported Definition Risk Factor Date Reported Requirements The assessment results lose validity the more time elapses from when they are first made. Comments See Mappings Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Event.occurrence[x] w5: FiveWs.done[x] rim: .effectiveTime source-PIR: RISK_FACTORS.REPORTED_DATE source-PHSL: reportedDate
  id		0..0	string	There are no (further) constraints on this element Element id RiskAssessment.occurrence[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id RiskAssessment.occurrence[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  value		0..1	System.DateTime	There are no (further) constraints on this element Element id RiskAssessment.occurrence[x].value Short description Primitive value for dateTime Definition Primitive value for dateTime Data type System.DateTime
  condition	Σ C	0..1	Reference(Condition)	There are no (further) constraints on this element Element id RiskAssessment.condition Short description Condition assessed Definition For assessments or prognosis specific to a particular condition, indicates the condition being assessed. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Condition) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .outboundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN]
  performer	Σ C	0..1	Reference(Device | Practitioner | PractitionerRole)	There are no (further) constraints on this element Element id RiskAssessment.performer Short description Who did assessment? Definition The provider or software application that performed the assessment. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Device | Practitioner | PractitionerRole) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.performer.actor w5: FiveWs.actor rim: .participation[typeCode=PFM].role[classCode=ASSIGNED] openehr: Information Provider
  reasonCode		0..1	CodeableConcept	There are no (further) constraints on this element Element id RiskAssessment.reasonCode Short description Why the assessment was necessary? Definition The reason the risk assessment was performed. Comments 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. Data type CodeableConcept Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.reasonCode w5: FiveWs.why[x]
  reasonReference	C	0..1	Reference(Condition | DiagnosticReport | DocumentReference | Observation)	There are no (further) constraints on this element Element id RiskAssessment.reasonReference Short description Why the assessment was necessary? Definition Resources supporting the reason the risk assessment was performed. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Condition | DiagnosticReport | DocumentReference | Observation) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.reasonReference w5: FiveWs.why[x]
  basis	C	0..1	Reference(Resource)	There are no (further) constraints on this element Element id RiskAssessment.basis Short description Information used in assessment Definition Indicates the source data considered as part of the assessment (for example, FamilyHistory, Observations, Procedures, Conditions, etc.). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Resource) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .outboundRelationship[typeCode=DRIV].target openehr: Risk Factor; Link to Evidence
  prediction	C	1..*	BackboneElement	Element id RiskAssessment.prediction Short description Risk Factor PIR Code and Description Definition Risk Factor PIR Code and Description Comments Multiple repetitions can be used to identify the same type of outcome in different timeframes as well as different types of outcomes. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ras-2: Must be <= 100 probability is decimal implies (probability as decimal) <= 100 Mappings rim: n/a rim: .outboundRelationship[typeCode=VALUE].target[classCod=OBS, moodCode=RISK]
  id		0..1	string	There are no (further) constraints on this element Element id RiskAssessment.prediction.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id RiskAssessment.prediction.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id RiskAssessment.prediction.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  outcome		1..1	CodeableConcept	Element id RiskAssessment.prediction.outcome Short description Possible outcome for the subject Definition One of the potential outcomes for the patient (e.g. remission, death, a particular condition). Comments For IDS Phase 5.2: Only send code with description ends with (*) Data type CodeableConcept Binding The condition or other outcome; e.g. death, remission, amputation, infection, etc. (unbound) (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: .value openehr: Risk
  id		0..1	string	There are no (further) constraints on this element Element id RiskAssessment.prediction.outcome.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id RiskAssessment.prediction.outcome.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	1..1	Coding	There are no (further) constraints on this element Element id RiskAssessment.prediction.outcome.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id RiskAssessment.prediction.outcome.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id RiskAssessment.prediction.outcome.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id RiskAssessment.prediction.outcome.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem source-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code
  version	Σ	0..1	string	There are no (further) constraints on this element Element id RiskAssessment.prediction.outcome.coding.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id RiskAssessment.prediction.outcome.coding.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments See Mappings Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code source-PIR: BCYREPORTNG.RBCY_FN_GET_CONCEPT_CODE (RISK_FACTORS.RISK_FACTOR_CODE_CNCPT_ID) source-PHSL: riskFactorCode
  display	Σ	1..1	string	Element id RiskAssessment.prediction.outcome.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName source-PIR: REPORTNG.GET_ITERM_DESC(RISK_FACTORS.RISK_FACTOR_CODE_CNCPT_ID) source-PHSL: riskFactorDescription
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id RiskAssessment.prediction.outcome.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	There are no (further) constraints on this element Element id RiskAssessment.prediction.outcome.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments Very often the text is the same as a displayName of one of the codings. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  probability[x]	C	0..1		There are no (further) constraints on this element Element id RiskAssessment.prediction.probability[x] Short description Likelihood of specified outcome Definition Indicates how likely the outcome is (in the specified timeframe). Comments If range is used, it represents the lower and upper bounds of certainty; e.g. 40-60% Decimal values are expressed as percentages as well (max = 100). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ras-1: low and high must be percentages, if present (low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum))) Mappings rim: n/a rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="probability"].value openehr: Category
  probabilityDecimal			decimal	There are no (further) constraints on this element Data type decimal
  probabilityRange			Range	There are no (further) constraints on this element Data type Range
  qualitativeRisk		0..1	CodeableConcept	There are no (further) constraints on this element Element id RiskAssessment.prediction.qualitativeRisk Short description Likelihood of specified outcome as a qualitative value Definition Indicates how likely the outcome is (in the specified timeframe), expressed as a qualitative value (e.g. low, medium, or high). Comments 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. Data type CodeableConcept Binding The likelihood of the occurrence of a specified outcome. RiskProbability (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  relativeRisk		0..1	decimal	There are no (further) constraints on this element Element id RiskAssessment.prediction.relativeRisk Short description Relative likelihood Definition Indicates the risk for this particular subject (with their specific characteristics) divided by the risk of the population in general. (Numbers greater than 1 = higher risk than the population, numbers less than 1 = lower risk.). Requirements Absolute risk is less meaningful than relative risk. Comments Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger) Data type decimal Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="relative risk"].value
  when[x]		0..1	Period	Element id RiskAssessment.prediction.when[x] Short description Risk Factor Timeframe Definition Risk Factor Timeframe: Start Date, End Date Comments If not specified, the risk applies "over the subject's lifespan". Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .effectiveTime or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age"].value
  id		0..1	string	There are no (further) constraints on this element Element id RiskAssessment.prediction.when[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id RiskAssessment.prediction.when[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  start	Σ C	0..1	dateTime	Element id RiskAssessment.prediction.when[x].start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments See Mappings Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1, per-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: DR.1 rim: ./low source-PIR: RISK_FACTORS.START_DATE source-PHSL: effectiveFromDate
  end	Σ C	0..1	dateTime	Element id RiskAssessment.prediction.when[x].end Short description End time with inclusive boundary, if not ongoing Definition The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments See Mappings Meaning when missing If the end of the period is missing, it means that the period is ongoing Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1, per-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: DR.2 rim: ./high source-PIR: RISK_FACTORS.END_DATE source-PHSL: effectiveTo
  rationale		1..1	string	Element id RiskAssessment.prediction.rationale Short description Risk Factor RESPONSE in PIR Definition Risk Factor RESPONSE in PIR. Possible RESPONSE values are "Asked but Unknown" / "Declined to answer" / "Entered in error" / "Yes" / "No" / "Not assessed", but only Response = YES will be send in IDS. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .reasonCode.text openehr: Rationale source-PIR: BCYREPORTNG.RBCY_FN_GET_CONCEPT_CODE (RISK_FACTORS.RISK_FACTOR_RESP_CODE_CNCPT_ID) + " - "+REPORTNG.GET_ITERM_DESC(RISK_FACTORS.RISK_FACTOR_RESP_CODE_CNCPT_ID) source-PHSL: riskFacotrResponse
  mitigation		0..1	string	There are no (further) constraints on this element Element id RiskAssessment.mitigation Short description How to reduce risk Definition A description of the steps that might be taken to reduce the identified risk(s). Requirements One of the main reasons for assessing risks is to identify whether interventional steps are needed to reduce risk. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .outboundRelationship[typeCode=MTGT].target[classCode=ACT, moodCode=EVN].text
  note		0..1	Annotation	Element id RiskAssessment.note Short description Risk Factor Comments Definition Additional comments about the risk factor Comments For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible). Data type Annotation Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act workflow: Event.note
  id		0..0	string	There are no (further) constraints on this element Element id RiskAssessment.note.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..0	Extension	There are no (further) constraints on this element Element id RiskAssessment.note.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  author[x]	Σ	0..0		There are no (further) constraints on this element Element id RiskAssessment.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Comments Organization is used when there's no need for specific attribution as to who made the comment. Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act.participant[typeCode=AUT].role
  time	Σ	0..1	dateTime	There are no (further) constraints on this element Element id RiskAssessment.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act.effectiveTime
  text	Σ	1..1	markdown	Element id RiskAssessment.note.text Short description The annotation - text content (as markdown) Definition The text of the annotation in markdown format. Comments See Mappings Data type markdown Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act.text source-PIR: RISK_FACTORS.OTHER_RISK_FACTOR source-PHSL: additionalInformation

• MedicationRequest

  The MedicationRequest resource is used for deferrals of immunization due to various reasons such as medical contraindications or other factors. The resource includes the deferral reason and the time frame during which the immunization is deferred, aiding healthcare providers in managing patient-specific immunization schedules.

  MedicationRequest	C		MedicationRequest	Element id MedicationRequest Short description FHIR resource applies for PIR Vaccine Deferrals Alternate names Prescription, Order Definition FHIR resource applies for PIR Vaccine Deferrals Data type MedicationRequest Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act workflow: Request script10.6: Message/Body/NewRx rim: CombinedMedicationRequest
  id	Σ	1..1	id	Element id MedicationRequest.id Short description PIR internal Deferral ID Definition PIR internal Deferral Identifier. Comments See Mappings. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a source-PIR: H33_PATIENT_VACCINE_DEFERRAL.PATIENT_VACCINE_DEFERRAL_ID source-PHSL: deferralID
  meta	Σ	1..1	Meta	There are no (further) constraints on this element Element id MedicationRequest.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  versionId	Σ	0..1	id	Element id MedicationRequest.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments Apply "2025.01.1". This indicates the FHIR Specs as of year 2025 Jan. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastUpdated	Σ	0..1	instant	Element id MedicationRequest.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments Updated: Relax the previously crossed-out elements. Data type instant Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  source	Σ	0..1	uri	There are no (further) constraints on this element Element id MedicationRequest.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  profile	Σ	1..1	canonical(StructureDefinition)	Element id MedicationRequest.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments Apply "http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/MedicationRequest" Data type canonical(StructureDefinition) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  security	Σ	0..1	CodingBinding	There are no (further) constraints on this element Element id MedicationRequest.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  tag	Σ	0..1	Coding	There are no (further) constraints on this element Element id MedicationRequest.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id MedicationRequest.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..1	codeBinding	There are no (further) constraints on this element Element id MedicationRequest.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Binding extensions MaxValueSet AllLanguages Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..1	Narrative	There are no (further) constraints on this element Element id MedicationRequest.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		0..1	Resource	There are no (further) constraints on this element Element id MedicationRequest.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
  extension	C	2..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRIdentifierExtension	C	1..1	Extension(string)	Element id MedicationRequest.extension:pIRIdentifierExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(string) Extension URL PIRIdentifierExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRLockSeqNumberExtension	C	1..1	Extension(integer)	Element id MedicationRequest.extension:pIRLockSeqNumberExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(integer) Extension URL PIRLockSeqNumberExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	?! C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  identifier		1..*	Identifier	Element id MedicationRequest.identifier Short description PIR internal Deferral ID + External Deferral ID from source system(s) Definition PIR internal Deferral Identifier + External Deferral ID from source system(s) Comments This is a business identifier, not a resource identifier. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier workflow: Request.identifier script10.6: Message/Header/PrescriberOrderNumber w5: FiveWs.identifier v2: ORC-2-Placer Order Number / ORC-3-Filler Order Number rim: .id
  id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationRequest.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Role.code or implied by context
  type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id MedicationRequest.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments 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. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
  id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.identifier.type.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.identifier.type.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	0..0	Coding	There are no (further) constraints on this element Element id MedicationRequest.identifier.type.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  text	Σ	1..1	string	Element id MedicationRequest.identifier.type.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: PANORAMAIMMZDEFERID
  system	Σ	1..1	uri	Element id MedicationRequest.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType source-PIR: https://health.gov.bc.ca/fhir/NamingSystem/ca-bc-panorama-immunization-deferral-id
  value	Σ	1..1	string	Element id MedicationRequest.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 123456 Mappings rim: n/a v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value source-PIR: H33_PATIENT_VACCINE_DEFERRAL.PATIENT_VACCINE_DEFERRAL_ID
  period	Σ C	0..1	Period	There are no (further) constraints on this element Element id MedicationRequest.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
  assigner	Σ C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id MedicationRequest.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments 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. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
  status	Σ ?!	1..1	codeBinding	Element id MedicationRequest.status Short description PIR applies: | active | cancelled | Definition PIR applies possible statuses : | active | cancelled | Comments See Mappings Data type code Binding A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. medicationrequest Status (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.status script10.6: no mapping w5: FiveWs.status rim: .statusCode source-PIR-active: active source-PIR-deleted: cancelled
  id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.status.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.status.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  _status	C	0..1	Extension(Complex)	Element id MedicationRequest.status.extension:_status Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments To be applied if Deferral has been deleted in PIR Data type Extension(Complex) Extension URL DeferralStatusExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id MedicationRequest.status.extension:_status.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.status.extension:_status.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  deferralDeleteReason	C	0..1	Extension	Element id MedicationRequest.status.extension:_status.extension:deferralDeleteReason Short description Deferral Delete Reason Alternate names extensions, user content Definition Deferral Delete Reason Comments To be applied if Deferral has been deleted with reason in PIR drop-down list or NO Delete Reason provided. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A source-PIR-nullReason: Other
  id		0..0	string	There are no (further) constraints on this element Element id MedicationRequest.status.extension:_status.extension:deferralDeleteReason.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.status.extension:_status.extension:deferralDeleteReason.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationRequest.status.extension:_status.extension:deferralDeleteReason.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value deferralDeleteReason Mappings rim: N/A
  value[x]		0..1		There are no (further) constraints on this element Element id MedicationRequest.status.extension:_status.extension:deferralDeleteReason.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  valueString			string	There are no (further) constraints on this element Data type string
  deferralDeleteReasonOther	C	0..1	Extension	Element id MedicationRequest.status.extension:_status.extension:deferralDeleteReasonOther Short description Deferral Delete Reason Other, specify Alternate names extensions, user content Definition Deferral Delete Reason Other, specify Comments To be applied when Deferral has been deleted with OTHER reason not listed in PIR drop-down list or NO deletion reason is provided. See Mappings. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A source-PIR-null: unknown
  id		0..0	string	There are no (further) constraints on this element Element id MedicationRequest.status.extension:_status.extension:deferralDeleteReasonOther.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.status.extension:_status.extension:deferralDeleteReasonOther.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationRequest.status.extension:_status.extension:deferralDeleteReasonOther.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value deferralDeleteReasonOther Mappings rim: N/A
  value[x]		0..1		There are no (further) constraints on this element Element id MedicationRequest.status.extension:_status.extension:deferralDeleteReasonOther.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  valueString			string	There are no (further) constraints on this element Data type string
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationRequest.status.extension:_status.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/deferral-status Mappings rim: N/A
  value[x]		0..0		There are no (further) constraints on this element Element id MedicationRequest.status.extension:_status.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  value		0..1	System.String	There are no (further) constraints on this element Element id MedicationRequest.status.value Short description Primitive value for code Definition Primitive value for code Data type System.String Maximum string length 1048576
  statusReason		1..1	CodeableConcept	Element id MedicationRequest.statusReason Short description PIR Deferral Reason Definition PIR Deferral Reason Comments Reason for Deferral Data type CodeableConcept Binding Identifies the reasons for a given status. medicationRequest Status Reason Codes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.statusReason rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
  id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.statusReason.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.statusReason.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	1..1	Coding	There are no (further) constraints on this element Element id MedicationRequest.statusReason.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..0	string	There are no (further) constraints on this element Element id MedicationRequest.statusReason.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.statusReason.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id MedicationRequest.statusReason.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem source-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code
  version	Σ	0..0	string	There are no (further) constraints on this element Element id MedicationRequest.statusReason.coding.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id MedicationRequest.statusReason.coding.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments See Mappings Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code source-PIR: BCYREPORTNG.RBCY_FN_GET_CONCEPT_CODE (H33_PATIENT_VACCINE_DEFERRAL.DEFERRAL_REASON_CD_CNCPT_ID) source-PHSL: reasonCode
  display	Σ	1..1	string	Element id MedicationRequest.statusReason.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName source-PIR: REPORTNG.GET_ITERM_DESC (H33_PATIENT_VACCINE_DEFERRAL.DEFERRAL_REASON_CD_CNCPT_ID) source-PHSL: reasonDescription
  userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id MedicationRequest.statusReason.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.statusReason.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments Very often the text is the same as a displayName of one of the codings. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  intent	Σ ?!	1..1	codeBinding	Element id MedicationRequest.intent Short description PIR applies | order | for FHIR purposes Definition PIR applies | order | for FHIR purposes Comments Apply "order" Data type code Binding The kind of medication order. medicationRequest Intent (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.intent w5: FiveWs.class rim: .moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
  category		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationRequest.category Short description Type of medication usage Definition Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). Comments The category can be used to include where the medication is expected to be consumed or other types of requests. Data type CodeableConcept Binding A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. medicationRequest Category Codes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD script10.6: Message/Body/NewRx/MedicationPrescribed/Directions or Message/Body/NewRx/MedicationPrescribed/StructuredSIG w5: FiveWs.class rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
  priority	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationRequest.priority Short description routine | urgent | asap | stat Definition Indicates how quickly the Medication Request should be addressed with respect to other requests. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding Identifies the level of importance to be assigned to actioning the request. RequestPriority (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.priority w5: FiveWs.grade rim: .priorityCode
  doNotPerform	Σ ?!	1..1	boolean	Element id MedicationRequest.doNotPerform Short description True if request is deferring vaccine Definition If true indicates that the provider is asking for the vaccine not to occur. Comments Apply "true" for deferral. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: SubstanceAdministration.actionNegationInd
  reported[x]	Σ	0..1		There are no (further) constraints on this element Element id MedicationRequest.reported[x] Short description Reported rather than primary record Definition Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report. Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .participation[typeCode=INF].role
  reportedBoolean			boolean	There are no (further) constraints on this element Data type boolean
  reportedReference			Reference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)	There are no (further) constraints on this element Data type Reference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
  medication[x]	Σ	1..1	CodeableConcept	Element id MedicationRequest.medication[x] Short description Vaccine to be deferred Definition Agent/antigen vaccine to be deferred Comments If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource. Data type CodeableConcept Binding A coded concept identifying substance or product that can be ordered. SNOMEDCTMedicationCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.code script10.6: Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription w5: FiveWs.what[x] v2: RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code rim: consumable.administrableMedication
  id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.medication[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.medication[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	1..1	Coding	Element id MedicationRequest.medication[x].coding Short description 1st instance Agent in NVC code, 2nd instance Agent in PIR code Definition 1st instance Agent in NVC code, 2nd instance Agent in PIR code Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 1st instance Agent/Antigen in NVC code, 2nd instance Agent/Antigen in PIR code. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.medication[x].coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.medication[x].coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id MedicationRequest.medication[x].coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 1st instance Agent in NVC code, 2nd instance Agent in PIR code. See Mappings. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem code-NVC: https://nvc-cnv.canada.ca code-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code
  version	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.medication[x].coding.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id MedicationRequest.medication[x].coding.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments See Mappings Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code source-PIR: BCYREPORTNG.RBCY_FN_GET_CONCEPT_CODE (H33_PATIENT_VACCINE_DEFERRAL.ASIIS_VACC_CODE) source-PHSL: agentCode
  display	Σ	1..1	string	Element id MedicationRequest.medication[x].coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName source-PIR: REPORTNG.GET_ITERM_DESC (H33_PATIENT_VACCINE_DEFERRAL.ASIIS_VACC_CODE) source-PHSL: agentDescription
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id MedicationRequest.medication[x].coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..0	string	There are no (further) constraints on this element Element id MedicationRequest.medication[x].text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments Very often the text is the same as a displayName of one of the codings. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  subject	Σ C	1..1	Reference(Group | Patient)	There are no (further) constraints on this element Element id MedicationRequest.subject Short description Who or group medication request is for Definition A link to a resource representing the person or set of individuals to whom the medication will be given. Comments The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified. Data type Reference(Group | Patient) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.subject script10.6: Message/Body/NewRx/Patient (need detail to link to specific patient … Patient.Identification in SCRIPT) w5: FiveWs.subject[x] v2: PID-3-Patient ID List rim: .participation[typeCode=AUT].role w5: FiveWs.subject
  id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.subject.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.subject.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	1..1	string	Element id MedicationRequest.subject.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: fullURL of Panorama + "Patient" + PIR Client ID
  type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id MedicationRequest.subject.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationRequest.subject.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.subject.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  encounter	C	0..1	Reference(Encounter)	There are no (further) constraints on this element Element id MedicationRequest.encounter Short description Encounter created as part of encounter/admission/stay Definition The Encounter during which this [x] was created or to which the creation of this record is tightly associated. Comments 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." If there is a need to link to episodes of care they will be handled with an extension. Data type Reference(Encounter) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.context script10.6: no mapping w5: FiveWs.context v2: PV1-19-Visit Number rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
  supportingInformation	C	0..1	Reference(Resource)	There are no (further) constraints on this element Element id MedicationRequest.supportingInformation Short description Information to support ordering of the medication Definition Include additional information (for example, patient height and weight) that supports the ordering of the medication. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Resource) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.supportingInfo w5: FiveWs.context rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]
  authoredOn	Σ	0..1	dateTime	There are no (further) constraints on this element Element id MedicationRequest.authoredOn Short description When request was initially authored Definition The date (and perhaps time) when the prescription was initially written or authored on. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.authoredOn script10.6: Message/Body/NewRx/MedicationPrescribed/WrittenDate w5: FiveWs.recorded v2: RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction rim: author.time
  requester	Σ C	0..1	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)	There are no (further) constraints on this element Element id MedicationRequest.requester Short description Who/What requested the Request Definition The individual, organization, or device that initiated the request and has responsibility for its activation. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.requester w5: FiveWs.author rim: .participation[typeCode=AUT].role
  performer	C	0..1	Reference(CareTeam | Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)	There are no (further) constraints on this element Element id MedicationRequest.performer Short description Intended performer of administration Definition The specified desired performer of the medication treatment (e.g. the performer of the medication administration). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareTeam | Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.performer w5: FiveWs.actor rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
  performerType	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationRequest.performerType Short description Desired kind of performer of the medication administration Definition Indicates the type of performer of the administration of the medication. Comments If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available. Data type CodeableConcept Binding Identifies the type of individual that is desired to administer the medication. ProcedurePerformerRoleCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.performerType rim: .participation[typeCode=PRF].role[scoper.determinerCode=KIND].code
  recorder	C	0..1	Reference(Practitioner | PractitionerRole)	There are no (further) constraints on this element Element id MedicationRequest.recorder Short description Person who entered the request Definition The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Practitioner | PractitionerRole) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.who rim: .participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)
  reasonCode		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationRequest.reasonCode Short description Reason or indication for ordering or not ordering the medication Definition The reason or the indication for ordering or not ordering the medication. Comments This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference. Data type CodeableConcept Binding A coded concept indicating why the medication was ordered. Condition/Problem/DiagnosisCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.reasonCode script10.6: Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value w5: FiveWs.why[x] v2: ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication rim: reason.observation.reasonCode
  reasonReference	C	0..1	Reference(Condition | Observation)	There are no (further) constraints on this element Element id MedicationRequest.reasonReference Short description Condition or observation that supports why the prescription is being written Definition Condition or observation that supports why the medication was ordered. Comments This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode. Data type Reference(Condition | Observation) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.reasonReference script10.6: no mapping w5: FiveWs.why[x] rim: reason.observation[code=ASSERTION].value
  instantiatesCanonical	Σ	0..1	canonical	There are no (further) constraints on this element Element id MedicationRequest.instantiatesCanonical Short description Instantiates FHIR protocol or definition Definition The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest. Comments see Canonical References Data type canonical Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.instantiates rim: .outboundRelationship[typeCode=DEFN].target
  instantiatesUri	Σ	0..1	uri	There are no (further) constraints on this element Element id MedicationRequest.instantiatesUri Short description Instantiates external protocol or definition Definition The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .outboundRelationship[typeCode=DEFN].target
  basedOn	Σ C	0..1	Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | ServiceRequest)	There are no (further) constraints on this element Element id MedicationRequest.basedOn Short description What request fulfills Definition A plan or request that is fulfilled in whole or in part by this medication request. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | ServiceRequest) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.basedOn rim: .outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
  groupIdentifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationRequest.groupIdentifier Short description Composite request this is part of Definition A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription. Requirements Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier workflow: Request.groupIdentifier rim: .outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id
  courseOfTherapyType		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationRequest.courseOfTherapyType Short description Overall pattern of medication administration Definition The description of the overall patte3rn of the administration of the medication to the patient. Comments This attribute should not be confused with the protocol of the medication. Data type CodeableConcept Binding Identifies the overall pattern of medication administratio. medicationRequest Course of Therapy Codes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: Act.code where classCode = LIST and moodCode = EVN
  insurance	C	0..1	Reference(ClaimResponse | Coverage)	There are no (further) constraints on this element Element id MedicationRequest.insurance Short description Associated insurance coverage Definition Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(ClaimResponse | Coverage) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.insurance rim: .outboundRelationship[typeCode=COVBY].target
  note		0..1	Annotation	Element id MedicationRequest.note Short description Comments about the deferral. Definition Comments about the deferral. Comments See Mappings Data type Annotation Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act workflow: Request.note script10.6: Message/Body/NewRx/MedicationPrescribed/Note rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value source-PIR: Comments
  id		0..0	string	There are no (further) constraints on this element Element id MedicationRequest.note.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	2..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.note.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRIdentifierExtension	C	1..1	Extension(string)	Element id MedicationRequest.note.extension:pIRIdentifierExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(string) Extension URL PIRIdentifierExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRLockSeqNumberExtension	C	1..1	Extension(integer)	Element id MedicationRequest.note.extension:pIRLockSeqNumberExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(integer) Extension URL PIRLockSeqNumberExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  author[x]	Σ	0..0		There are no (further) constraints on this element Element id MedicationRequest.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Comments Organization is used when there's no need for specific attribution as to who made the comment. Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act.participant[typeCode=AUT].role
  time	Σ	0..1	dateTime	There are no (further) constraints on this element Element id MedicationRequest.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act.effectiveTime
  text	Σ	1..1	markdown	Element id MedicationRequest.note.text Short description The annotation - text content (as markdown) Definition The text of the annotation in markdown format. Comments Deferral Comments. Data type markdown Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act.text
  dosageInstruction		0..1	Dosage	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction Short description How the medication should be taken Definition Indicates how the medication is to be used by the patient. Comments There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed. Data type Dosage Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT] workflow: Request.occurrence[x] rim: see dosageInstruction mapping
  dispenseRequest		1..1	BackboneElement	Element id MedicationRequest.dispenseRequest Short description Deferral date range authorized. Definition Deferral date range authorized.. Note Start Date is mandatory but End Date is optional. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a script10.6: Message/Body/NewRx/MedicationPrescribed/ExpirationDate rim: component.supplyEvent
  id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  initialFill		0..1	BackboneElement	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.initialFill Short description First fill details Definition Indicates the quantity or duration for the first dispense of the medication. Comments If populating this element, either the quantity or the duration must be included. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply
  id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.initialFill.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.initialFill.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.initialFill.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  quantity	C	0..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.initialFill.quantity Short description First fill quantity Definition The amount or quantity to provide as part of the first dispense. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type SimpleQuantity Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) qty-3: If a code for the unit is present, the system SHALL also be present code.empty() or system.exists() sqty-1: The comparator is not used on a SimpleQuantity comparator.empty() Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values rim: Supply.quantity[moodCode=RQO]
  duration	C	0..1	Duration	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.initialFill.duration Short description First fill duration Definition The length of time that the first dispense is expected to last. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type Duration Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) qty-3: If a code for the unit is present, the system SHALL also be present code.empty() or system.exists() drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. code.exists() implies ((system = %ucum) and value.exists()) Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values rim: PQ, IVL<PQ> depending on the values rim: Supply.effectivetime[moodCode=RQO]
  dispenseInterval	C	0..1	Duration	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.dispenseInterval Short description Minimum period of time between dispenses Definition The minimum period of time that must occur between dispenses of the medication. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type Duration Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) qty-3: If a code for the unit is present, the system SHALL also be present code.empty() or system.exists() drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. code.exists() implies ((system = %ucum) and value.exists()) Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values rim: PQ, IVL<PQ> depending on the values rim: Supply.effectivetime[moodCode=RQO]
  validityPeriod	C	1..1	Period	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.validityPeriod Short description Time period supply is authorized for Definition This indicates the validity period of a prescription (stale dating the Prescription). Requirements Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription. Comments It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] script10.6: Message/Body/NewRx/MedicationPrescribed/Refills rim: effectiveTime
  id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.validityPeriod.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.validityPeriod.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  start	Σ C	1..1	dateTime	Element id MedicationRequest.dispenseRequest.validityPeriod.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments If the low element is missing, the meaning is that the low boundary is not known. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1, per-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: DR.1 rim: ./low source-PIR: IMMS.H33_PATIENT_VACCINE_DEFERRAL.DEFERRAL_DATE source-PHSL: deffFrom
  end	Σ C	0..1	dateTime	Element id MedicationRequest.dispenseRequest.validityPeriod.end Short description End time with inclusive boundary, if not ongoing Definition The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments See Mappings Meaning when missing If the end of the period is missing, it means that the period is ongoing Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1, per-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: DR.2 rim: ./high source-PIR: IMMS.H33_PATIENT_VACCINE_DEFERRAL.DEFERRAL_END_DATE source-PHSL: deffTo
  numberOfRepeatsAllowed		0..1	unsignedInt	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.numberOfRepeatsAllowed Short description Number of refills authorized Definition An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense. Comments If displaying "number of authorized fills", add 1 to this number. Data type unsignedInt Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a script10.6: Message/Body/NewRx/MedicationPrescribed/Quantity v2: RXE-12-Number of Refills rim: repeatNumber
  quantity	C	0..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.quantity Short description Amount of medication to supply per dispense Definition The amount that is to be dispensed for one fill. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type SimpleQuantity Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) qty-3: If a code for the unit is present, the system SHALL also be present code.empty() or system.exists() sqty-1: The comparator is not used on a SimpleQuantity comparator.empty() Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values script10.6: Message/Body/NewRx/MedicationPrescribed/DaysSupply v2: RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system rim: quantity
  expectedSupplyDuration	C	0..1	Duration	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.expectedSupplyDuration Short description Number of days supply per dispense Definition Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last. Comments In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage). When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors. Data type Duration Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) qty-3: If a code for the unit is present, the system SHALL also be present code.empty() or system.exists() drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. code.exists() implies ((system = %ucum) and value.exists()) Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values rim: PQ, IVL<PQ> depending on the values script10.6: Message/Body/NewRx/MedicationPrescribed/Substitutions rim: expectedUseTime
  performer	C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.performer Short description Intended dispenser Definition Indicates the intended dispensing Organization specified by the prescriber. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.who rim: .outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
  substitution		0..1	BackboneElement	There are no (further) constraints on this element Element id MedicationRequest.substitution Short description Any restrictions on medication substitution Definition Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions rim: subjectOf.substitutionPersmission
  id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.substitution.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.substitution.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.substitution.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  allowed[x]		1..1		There are no (further) constraints on this element Element id MedicationRequest.substitution.allowed[x] Short description Whether substitution is allowed or not Definition True if the prescriber allows a different drug to be dispensed from what was prescribed. Comments This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored. Binding Identifies the type of substitution allowed. v3.ActSubstanceAdminSubstitutionCode (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status rim: code
  allowedBoolean			boolean	There are no (further) constraints on this element Data type boolean
  allowedCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
  reason		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationRequest.substitution.reason Short description Why should (not) substitution be made Definition Indicates the reason for the substitution, or why substitution must or must not be performed. Comments 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. Data type CodeableConcept Binding A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. v3.SubstanceAdminSubstitutionReason (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD script10.6: not mapped v2: RXE-9 Substition status rim: reasonCode
  priorPrescription	C	0..1	Reference(MedicationRequest)	There are no (further) constraints on this element Element id MedicationRequest.priorPrescription Short description An order/prescription that is being replaced Definition A link to a resource representing an earlier order related order or prescription. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(MedicationRequest) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.replaces script10.6: not mapped rim: .outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]
  detectedIssue	C	0..1	Reference(DetectedIssue)	There are no (further) constraints on this element Element id MedicationRequest.detectedIssue Short description Clinical Issue with action Alternate names Contraindication, Drug Utilization Review (DUR), Alert Definition Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc. Comments This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue. Data type Reference(DetectedIssue) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value
  eventHistory	C	0..1	Reference(Provenance)	There are no (further) constraints on this element Element id MedicationRequest.eventHistory Short description A list of events of interest in the lifecycle Definition Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource. Comments This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.). Data type Reference(Provenance) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.relevantHistory rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

• CarePlan

  The CarePlan resource provides an outline of special considerations related to immunizations, including any medical conditions or factors that may influence immunization decisions. It includes references to relevant conditions and helps providers tailor care plans according to patient needs.

  CarePlan	C		CarePlan	Element id CarePlan Short description FHIR resource applies for PIR Special Considerations - Contraindication, Exemption, Precaution Alternate names Care Team Definition FHIR resource applies for PIR Special Considerations - Contraindication, Exemption, Precaution Comments resourceCarePlan contains resourceCondition for PIR Special Considerations data. Data type CarePlan Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act workflow: Request rim: Act[classCode=PCPR, moodCode=INT]
  id	Σ	1..1	id	Element id CarePlan.id Short description PIR internal Special Consideration ID Definition PIR internal Special Consideration Identifier Comments See Mappings Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a source-PIR: SPECIAL_CONSIDERATION.CONTRA_ID source-PHSL: specialConsiderationId
  meta	Σ	1..1	Meta	There are no (further) constraints on this element Element id CarePlan.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  id		0..1	string	There are no (further) constraints on this element Element id CarePlan.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  versionId	Σ	0..1	id	Element id CarePlan.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments Apply "2025.01.1". This indicates the FHIR Specs as of year 2025 Jan. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastUpdated	Σ	0..1	instant	Element id CarePlan.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments Updated: Relax the previously crossed-out elements. Data type instant Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  source	Σ	0..1	uri	There are no (further) constraints on this element Element id CarePlan.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  profile	Σ	1..1	canonical(StructureDefinition)	Element id CarePlan.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments Apply "http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/CarePlan" Data type canonical(StructureDefinition) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  security	Σ	0..1	CodingBinding	There are no (further) constraints on this element Element id CarePlan.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  tag	Σ	0..1	Coding	There are no (further) constraints on this element Element id CarePlan.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id CarePlan.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..1	codeBinding	There are no (further) constraints on this element Element id CarePlan.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Binding extensions MaxValueSet AllLanguages Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..1	Narrative	There are no (further) constraints on this element Element id CarePlan.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained	C	1..1	Condition	Element id CarePlan.contained Short description Contains resourceCondition as part of PIR Special Consideration Alternate names inline resources, anonymous resources, contained resources Definition Contains resourceCondition as part of PIR Special Consideration Comments resourceCondition is part of PIR Special Consideration Data type Condition Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty() con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists() con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty() Mappings rim: Entity. Role, or Act rim: N/A workflow: Event sct-concept: < 243796009 |Situation with explicit context| : 246090004 |Associated finding| = ( ( < 404684003 |Clinical finding| MINUS ( << 420134006 |Propensity to adverse reactions| OR << 473010000 |Hypersensitivity condition| OR << 79899007 |Drug interaction| OR << 69449002 |Drug action| OR << 441742003 |Evaluation finding| OR << 307824009 |Administrative status| OR << 385356007 |Tumor stage finding|)) OR < 272379006 |Event|) v2: PPR message rim: Observation[classCode=OBS, moodCode=EVN, code=ASSERTION, value<Diagnosis]
  extension	C	2..*	Extension	There are no (further) constraints on this element Element id CarePlan.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRIdentifierExtension	C	1..1	Extension(string)	Element id CarePlan.extension:pIRIdentifierExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(string) Extension URL PIRIdentifierExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRLockSeqNumberExtension	C	1..1	Extension(integer)	Element id CarePlan.extension:pIRLockSeqNumberExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(integer) Extension URL PIRLockSeqNumberExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	?! C	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  identifier	Σ	1..1	Identifier	Element id CarePlan.identifier Short description PIR internal Special Consideration Identifier + External Special Consideration ID from source system(s) Definition PIR internal Special Consideration Identifier + External Special Consideration ID from source system(s) Requirements Allows identification of the care plan as it is known by various participating systems and in a way that remains consistent across servers. Comments This is a business identifier, not a resource identifier (see discussion). 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. Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier workflow: Request.identifier w5: FiveWs.identifier v2: PTH-3 rim: .id
  id		0..1	string	There are no (further) constraints on this element Element id CarePlan.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id CarePlan.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Role.code or implied by context
  type	Σ	1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id CarePlan.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments 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. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
  id		0..1	string	There are no (further) constraints on this element Element id CarePlan.identifier.type.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.identifier.type.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	0..1	Coding	There are no (further) constraints on this element Element id CarePlan.identifier.type.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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 labeled as UserSelected = true. Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  text	Σ	1..1	string	Element id CarePlan.identifier.type.text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: "PANORAMASCID"
  system	Σ	1..1	uri	Element id CarePlan.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments Identifier.system is always case sensitive. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType source-PIR: https://health.gov.bc.ca/fhir/NamingSystem/ca-bc-panorama-immunization-special-consideration-id
  value	Σ	1..1	string	Element id CarePlan.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 123456 Mappings rim: n/a v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value source-PIR: SPECIAL_CONSIDERATION.CONTRA_ID source-PHSL: specialConsiderationId
  period	Σ C	0..1	Period	There are no (further) constraints on this element Element id CarePlan.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
  assigner	Σ C	0..1	Reference(Organization)	There are no (further) constraints on this element Element id CarePlan.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments 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. Data type Reference(Organization) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
  instantiatesCanonical	Σ	0..1	canonical(ActivityDefinition | Measure | OperationDefinition | PlanDefinition | Questionnaire)	There are no (further) constraints on this element Element id CarePlan.instantiatesCanonical Short description Instantiates FHIR protocol or definition Definition The URL pointing to a FHIR-defined protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan. Comments see Canonical References Data type canonical(ActivityDefinition | Measure | OperationDefinition | PlanDefinition | Questionnaire) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.instantiatesCanonical rim: .outboundRelationship[typeCode=DEFN].target
  instantiatesUri	Σ	0..1	uri	There are no (further) constraints on this element Element id CarePlan.instantiatesUri Short description Instantiates external protocol or definition Definition The URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan. Comments This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.instantiatesUri rim: .outboundRelationship[typeCode=DEFN].target
  basedOn	Σ C	0..1	Reference(CarePlan)	There are no (further) constraints on this element Element id CarePlan.basedOn Short description Fulfills CarePlan Alternate names fulfills Definition A care plan that is fulfilled in whole or in part by this care plan. Requirements Allows tracing of the care plan and tracking whether proposals/recommendations were acted upon. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CarePlan) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.basedOn
  replaces	Σ C	0..1	Reference(CarePlan)	There are no (further) constraints on this element Element id CarePlan.replaces Short description CarePlan replaced by this CarePlan Alternate names supersedes Definition Completed or terminated care plan whose function is taken by this new care plan. Requirements Allows tracing the continuation of a therapy or administrative process instantiated through multiple care plans. Comments The replacement could be because the initial care plan was immediately rejected (due to an issue) or because the previous care plan was completed, but the need for the action described by the care plan remains ongoing. Data type Reference(CarePlan) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.replaces
  partOf	Σ C	0..1	Reference(CarePlan)	There are no (further) constraints on this element Element id CarePlan.partOf Short description Part of referenced CarePlan Definition A larger care plan of which this particular care plan is a component or step. Comments Each care plan is an independent request, such that having a care plan be part of another care plan can cause issues with cascading statuses. As such, this element is still being discussed. Data type Reference(CarePlan) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  status	Σ ?!	1..1	codeBinding	Element id CarePlan.status Short description Possible status from PIR: | revoked | completed | Definition Possible status from PIR: | revoked | completed |. Revoked = deleted. Completed = active. Requirements Allows clinicians to determine whether the plan is actionable or not. Comments See Mappings Data type code Binding Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record. RequestStatus (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.status {uses different ValueSet} w5: FiveWs.status v2: PTH-5 rim: .statusCode planned = new active = active completed = completed source-PIR-active: completed source-PIR-deleted: revoked
  id		0..1	string	There are no (further) constraints on this element Element id CarePlan.status.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.status.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  _status	C	0..1	Extension(Complex)	Element id CarePlan.status.extension:_status Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments To be applied when Special Consideration is deleted in PIR. Data type Extension(Complex) Extension URL SpecialCondStatusExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id CarePlan.status.extension:_status.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.status.extension:_status.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  scDeleteReason	C	0..1	Extension	Element id CarePlan.status.extension:_status.extension:scDeleteReason Short description Special Consideration Deleted Reason Alternate names extensions, user content Definition Special Consideration Deleted Reason Other, specify Comments To be applied when Special Consideration has been deleted in PIR with reason found in PIR drop-down list or NO delete reason provided. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A source-PIR-nullReason: Other
  id		0..0	string	There are no (further) constraints on this element Element id CarePlan.status.extension:_status.extension:scDeleteReason.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.status.extension:_status.extension:scDeleteReason.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id CarePlan.status.extension:_status.extension:scDeleteReason.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value scDeleteReason Mappings rim: N/A
  value[x]		1..1		There are no (further) constraints on this element Element id CarePlan.status.extension:_status.extension:scDeleteReason.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  valueString			string	There are no (further) constraints on this element Data type string
  scDeleteReasonOther	C	0..1	Extension	Element id CarePlan.status.extension:_status.extension:scDeleteReasonOther Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments To be applied when Special Consideration has been deleted in PIR with reason not found in PIR drop-down list. See Mappings. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A source-PIR-null: unknown
  id		0..0	string	There are no (further) constraints on this element Element id CarePlan.status.extension:_status.extension:scDeleteReasonOther.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.status.extension:_status.extension:scDeleteReasonOther.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id CarePlan.status.extension:_status.extension:scDeleteReasonOther.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value scDeleteReasonOther Mappings rim: N/A
  value[x]		1..1		There are no (further) constraints on this element Element id CarePlan.status.extension:_status.extension:scDeleteReasonOther.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  valueString			string	There are no (further) constraints on this element Data type string
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id CarePlan.status.extension:_status.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/specialCond-status Mappings rim: N/A
  value[x]		0..0		There are no (further) constraints on this element Element id CarePlan.status.extension:_status.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  value		0..1	System.String	There are no (further) constraints on this element Element id CarePlan.status.value Short description Primitive value for code Definition Primitive value for code Data type System.String Maximum string length 1048576
  intent	Σ ?!	1..1	codeBinding	Element id CarePlan.intent Short description PIR applies value | order | for FHIR purposes only. Definition PIR applies value | order | for FHIR purposes only. Requirements Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain. Comments Apply "order" Data type code Binding Codes indicating the degree of authority/intentionality associated with a care plan. CarePlanIntent (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.intent
  category	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id CarePlan.category Short description Type of plan Definition Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc. Requirements Used for filtering what plan(s) are retrieved and displayed to different types of users. Comments There may be multiple axes of categorization and one plan may serve multiple purposes. In some cases, this may be redundant with references to CarePlan.concern. Data type CodeableConcept Binding Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc. CarePlanCategory (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.class
  title	Σ	0..1	string	There are no (further) constraints on this element Element id CarePlan.title Short description Human-friendly name for the care plan Definition Human-friendly name for the care plan. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  description	Σ	0..1	string	There are no (further) constraints on this element Element id CarePlan.description Short description Summary of nature of plan Definition A description of the scope and nature of the plan. Requirements Provides more detail than conveyed by category. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.what[x]
  subject	Σ C	1..1	Reference(Group | Patient)	There are no (further) constraints on this element Element id CarePlan.subject Short description Who the care plan is for Alternate names patient Definition Identifies the patient or group whose intended care is described by the plan. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Group | Patient) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.subject w5: FiveWs.subject[x] v2: PID-3 rim: .participation[typeCode=PAT].role[classCode=PAT] w5: FiveWs.subject
  id		0..1	string	There are no (further) constraints on this element Element id CarePlan.subject.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.subject.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	1..1	string	Element id CarePlan.subject.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: fullURL + "Patient/" + (Patient ID)
  type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id CarePlan.subject.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id CarePlan.subject.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..1	string	There are no (further) constraints on this element Element id CarePlan.subject.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  encounter	Σ C	0..1	Reference(Encounter)	There are no (further) constraints on this element Element id CarePlan.encounter Short description Encounter created as part of Definition The Encounter during which this CarePlan was created or to which the creation of this record is tightly associated. Comments 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. CarePlan activities conducted as a result of the care plan may well occur as part of other encounters. Data type Reference(Encounter) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.context w5: FiveWs.context v2: Associated PV1 rim: .
  period	Σ C	1..1	Period	There are no (further) constraints on this element Element id CarePlan.period Short description Time period plan covers Alternate names timing Definition Indicates when the plan did (or is intended to) come into effect and end. Requirements Allows tracking what plan(s) are in effect at a particular time. Comments Any activities scheduled as part of the plan should be constrained to the specified period regardless of whether the activities are planned within a single encounter/episode or across multiple encounters/episodes (e.g. the longitudinal management of a chronic condition). Data type Period Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] workflow: Request.occurrence[x] w5: FiveWs.planned v2: GOL-7 / GOL-8 rim: .effectiveTime
  id		0..0	string	There are no (further) constraints on this element Element id CarePlan.period.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.period.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  start	Σ C	1..1	dateTime	Element id CarePlan.period.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments See Mappings Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1, per-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: DR.1 rim: ./low source-PIR: SPECIAL_CONSIDERATION.EFFECTIVE_FROM_DATE source-PHSL: effectiveFrom
  end	Σ C	0..1	dateTime	Element id CarePlan.period.end Short description End time with inclusive boundary, if not ongoing Definition The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments See Mappings Meaning when missing If the end of the period is missing, it means that the period is ongoing Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1, per-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: DR.2 rim: ./high source-PIR: SPECIAL_CONSIDERATION.EFFECTIVE_TO_DATE source-PHSL: effectiveTo
  created	Σ	0..1	dateTime	There are no (further) constraints on this element Element id CarePlan.created Short description Date record was first recorded Alternate names authoredOn Definition Represents when this particular CarePlan record was created in the system, which is often a system-generated date. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.authoredOn w5: FiveWs.recorded rim: .participation[typeCode=AUT].time
  author	Σ C	0..1	Reference(CareTeam | Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)	There are no (further) constraints on this element Element id CarePlan.author Short description Who is the designated responsible party Definition When populated, the author is responsible for the care plan. The care plan is attributed to the author. Comments The author may also be a contributor. For example, an organization can be an author, but not listed as a contributor. Data type Reference(CareTeam | Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.requester w5: FiveWs.author
  contributor	C	0..1	Reference(CareTeam | Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)	There are no (further) constraints on this element Element id CarePlan.contributor Short description Who provided the content of the care plan Definition Identifies the individual(s) or organization who provided the contents of the care plan. Comments Collaborative care plans may have multiple contributors. Data type Reference(CareTeam | Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  careTeam	C	0..1	Reference(CareTeam)	There are no (further) constraints on this element Element id CarePlan.careTeam Short description Who's involved in plan? Definition Identifies all people and organizations who are expected to be involved in the care envisioned by this plan. Requirements Allows representation of care teams, helps scope care plan. In some cases may be a determiner of access permissions. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareTeam) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.performer {similar but does not entail CareTeam} w5: FiveWs.actor
  addresses	Σ C	0..1	Reference(Condition)	There are no (further) constraints on this element Element id CarePlan.addresses Short description Health issues this plan addresses Definition Identifies the conditions/problems/concerns/diagnoses/etc. whose management and/or mitigation are handled by this plan. Requirements Links plan to the conditions it manages. The element can identify risks addressed by the plan as well as active conditions. (The Condition resource can include things like "at risk for hypertension" or "fall risk".) Also scopes plans - multiple plans may exist addressing different concerns. Comments When the diagnosis is related to an allergy or intolerance, the Condition and AllergyIntolerance resources can both be used. However, to be actionable for decision support, using Condition alone is not sufficient as the allergy or intolerance condition needs to be represented as an AllergyIntolerance. Data type Reference(Condition) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.reasonReference w5: FiveWs.why[x] v2: PRB-4 rim: .actRelationship[typeCode=SUBJ].target[classCode=CONC, moodCode=EVN]
  supportingInfo	C	0..1	Reference(Resource)	There are no (further) constraints on this element Element id CarePlan.supportingInfo Short description Information considered as part of plan Definition Identifies portions of the patient's record that specifically influenced the formation of the plan. These might include comorbidities, recent procedures, limitations, recent assessments, etc. Requirements Identifies barriers and other considerations associated with the care plan. Comments Use "concern" to identify specific conditions addressed by the care plan. Data type Reference(Resource) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.supportingInfo
  goal	C	0..1	Reference(Goal)	There are no (further) constraints on this element Element id CarePlan.goal Short description Desired outcome of plan Definition Describes the intended objective(s) of carrying out the care plan. Requirements Provides context for plan. Allows plan effectiveness to be evaluated by clinicians. Comments Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline. Data type Reference(Goal) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: GOL.1 rim: .outboundRelationship[typeCode<=OBJ].
  activity	C	1..1	BackboneElement	There are no (further) constraints on this element Element id CarePlan.activity Short description Action to occur as part of plan Definition Identifies a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring, education, etc. Requirements Allows systems to prompt for performance of planned activities, and validate plans against best practice. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) cpl-3: Provide a reference or detail, not both detail.empty() or reference.empty() Mappings rim: n/a workflow: {no mapping NOTE: This is a list of contained Request-Event tuples!} rim: .outboundRelationship[typeCode=COMP].target
  id		0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.activity.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.activity.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  outcomeCodeableConcept		0..1	CodeableConcept	There are no (further) constraints on this element Element id CarePlan.activity.outcomeCodeableConcept Short description Results of the activity Definition Identifies the outcome at the point when the status of the activity is assessed. For example, the outcome of an education activity could be patient understands (or not). Comments Note that this should not duplicate the activity status (e.g. completed or in progress). Data type CodeableConcept Binding Identifies the results of the activity. CarePlanActivityOutcome (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  outcomeReference	C	0..1	Reference(Resource)	There are no (further) constraints on this element Element id CarePlan.activity.outcomeReference Short description Appointment, Encounter, Procedure, etc. Definition Details of the outcome or action resulting from the activity. The reference to an "event" resource, such as Procedure or Encounter or Observation, is the result/outcome of the activity itself. The activity can be conveyed using CarePlan.activity.detail OR using the CarePlan.activity.reference (a reference to a “request” resource). Requirements Links plan to resulting actions. Comments The activity outcome is independent of the outcome of the related goal(s). For example, if the goal is to achieve a target body weight of 150 lbs and an activity is defined to diet, then the activity outcome could be calories consumed whereas the goal outcome is an observation for the actual body weight measured. Data type Reference(Resource) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: {Event that is outcome of Request in activity.reference} rim: .inboundRelationship[typeCode=FLFS].source
  progress		0..1	Annotation	There are no (further) constraints on this element Element id CarePlan.activity.progress Short description Comments about the activity status/progress Definition Notes about the adherence/status/progress of the activity. Requirements Can be used to capture information about adherence, progress, concerns, etc. Comments This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description. Data type Annotation Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act v2: NTE? rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value
  reference	C	0..1	Reference(Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | RequestGroup | ServiceRequest | Task | VisionPrescription)	There are no (further) constraints on this element Element id CarePlan.activity.reference Short description Activity details defined in specific resource Definition The details of the proposed activity represented in a specific resource. Requirements Details in a form consistent with other applications and contexts of use. Comments Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference. The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan. Data type Reference(Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | RequestGroup | ServiceRequest | Task | VisionPrescription) Conditions The cardinality or value of this element may be affected by these constraints: ele-1, cpl-3 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: {Request that resulted in Event in activity.actionResulting} rim: .outboundRelationship[typeCode=COMP].target
  detail	C	1..1	BackboneElement	There are no (further) constraints on this element Element id CarePlan.activity.detail Short description In-line definition of activity Definition A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc. Requirements Details in a simple form for generic care plan systems. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: ele-1, cpl-3 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .outboundRelationship[typeCode=COMP, subsetCode=SUMM].target
  id		0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.activity.detail.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.activity.detail.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  kind		0..1	codeBinding	There are no (further) constraints on this element Element id CarePlan.activity.detail.kind Short description Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription Definition A description of the kind of resource the in-line definition of a care plan activity is representing. The CarePlan.activity.detail is an in-line definition when a resource is not referenced using CarePlan.activity.reference. For example, a MedicationRequest, a ServiceRequest, or a CommunicationRequest. Requirements May determine what types of extensions are permitted. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity. CarePlanActivityKind (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .inboundRelationship[typeCode=COMP].source[classCode=LIST].code
  instantiatesCanonical		0..1	canonical(ActivityDefinition | Measure | OperationDefinition | PlanDefinition | Questionnaire)	There are no (further) constraints on this element Element id CarePlan.activity.detail.instantiatesCanonical Short description Instantiates FHIR protocol or definition Definition The URL pointing to a FHIR-defined protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity. Requirements Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity. Comments see Canonical References Data type canonical(ActivityDefinition | Measure | OperationDefinition | PlanDefinition | Questionnaire) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.instantiatesCanonical rim: .outboundRelationship[typeCode=DEFN].target
  instantiatesUri		0..1	uri	There are no (further) constraints on this element Element id CarePlan.activity.detail.instantiatesUri Short description Instantiates external protocol or definition Definition The URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity. Requirements Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity. Comments This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier. Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.instantiatesUri rim: .outboundRelationship[typeCode=DEFN].target
  code		0..1	CodeableConcept	There are no (further) constraints on this element Element id CarePlan.activity.detail.code Short description Detail type of activity Definition Detailed description of the type of planned activity; e.g. what lab test, what procedure, what kind of encounter. Requirements Allows matching performed to planned as well as validation against protocols. Comments Tends to be less relevant for activities involving particular products. Codes should not convey negation - use "prohibited" instead. Data type CodeableConcept Binding Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter. ProcedureCodes(SNOMEDCT) (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.code v2: OBR-4 / RXE-2 / RXO-1 / RXD-2 rim: .code
  reasonCode		0..1	CodeableConcept	There are no (further) constraints on this element Element id CarePlan.activity.detail.reasonCode Short description Why activity should be done or why activity was prohibited Definition Provides the rationale that drove the inclusion of this particular activity as part of the plan or the reason why the activity was prohibited. Comments This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonCondition instead. Data type CodeableConcept Binding Identifies why a care plan activity is needed. Can include any health condition codes as well as such concepts as "general wellness", prophylaxis, surgical preparation, etc. SNOMEDCTClinicalFindings (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.reasonCode
  reasonReference	C	1..1	Reference(Condition | DiagnosticReport | DocumentReference | Observation)	There are no (further) constraints on this element Element id CarePlan.activity.detail.reasonReference Short description Why activity is needed Definition Indicates another resource, such as the health condition(s), whose existence justifies this request and drove the inclusion of this particular activity as part of the plan. Comments Conditions can be identified at the activity level that are not identified as reasons for the overall plan. Data type Reference(Condition | DiagnosticReport | DocumentReference | Observation) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.reasonReference
  id		0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.reasonReference.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.activity.detail.reasonReference.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	1..1	string	Element id CarePlan.activity.detail.reasonReference.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: "#Condition"+ (PIR SC ID)
  type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id CarePlan.activity.detail.reasonReference.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id CarePlan.activity.detail.reasonReference.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.reasonReference.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  goal	C	0..1	Reference(Goal)	There are no (further) constraints on this element Element id CarePlan.activity.detail.goal Short description Goals this activity relates to Definition Internal reference that identifies the goals that this activity is intended to contribute towards meeting. Requirements So that participants know the link explicitly. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Goal) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .outboundRelationship[typeCode<=OBJ].
  status	?!	1..1	codeBinding	Element id CarePlan.activity.detail.status Short description PIR applies | completed | for FHIR purposes. Definition PIR applies | completed | for FHIR purposes. Requirements Indicates progress against the plan, whether the activity is still relevant for the plan. Comments Apply "completed" Data type code Binding Codes that reflect the current state of a care plan activity within its overall life cycle. CarePlanActivityStatus (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.status v2: ORC-5? rim: .statusCode not-started = new scheduled = not-started (and fulfillment relationship to appointent) in-progress = active on-hold = suspended completed = completed cancelled = aborted
  statusReason		0..1	CodeableConcept	There are no (further) constraints on this element Element id CarePlan.activity.detail.statusReason Short description Reason for current status Definition Provides reason why the activity isn't yet started, is on hold, was cancelled, etc. Comments Will generally not be present if status is "complete". Be sure to prompt to update this (or at least remove the existing value) if the status is changed. Data type CodeableConcept Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.statusReason
  doNotPerform	?!	0..1	boolean	There are no (further) constraints on this element Element id CarePlan.activity.detail.doNotPerform Short description If true, activity is prohibiting action Definition If true, indicates that the described activity is one that must NOT be engaged in when following the plan. If false, or missing, indicates that the described activity is one that should be engaged in when following the plan. Requirements Captures intention to not do something that may have been previously typical. Comments This element is labeled as a modifier because it marks an activity as an activity that is not to be performed. Meaning when missing If missing indicates that the described activity is one that should be engaged in when following the plan. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.doNotPerform rim: actionNegationInd
  scheduled[x]		0..1		There are no (further) constraints on this element Element id CarePlan.activity.detail.scheduled[x] Short description When activity is to occur Definition The period, timing or frequency upon which the described activity is to occur. Requirements Allows prompting for activities and detection of missed planned activities. Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Request.occurrence[x] v2: TQ1 rim: .effectiveTime
  scheduledPeriod			Period	There are no (further) constraints on this element Data type Period
  scheduledString			string	There are no (further) constraints on this element Data type string
  scheduledTiming			Timing	There are no (further) constraints on this element Data type Timing
  location	C	0..1	Reference(Location)	There are no (further) constraints on this element Element id CarePlan.activity.detail.location Short description Where it should happen Definition Identifies the facility where the activity will occur; e.g. home, hospital, specific clinic, etc. Requirements Helps in planning of activity. Comments May reference a specific clinical location or may identify a type of location. Data type Reference(Location) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: OBR-24(???!!) rim: .participation[typeCode=LOC].role
  id		0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.location.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.activity.detail.location.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ C	1..1	string	Element id CarePlan.activity.detail.location.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-HA: "#Location/"(SDL_ID)+"org"+(BRANCH_ID) source-eForm: fullURL+"Location/"+(SDL_ID)+"org"+(BRANCH_ID)
  type	Σ	0..0	uriBinding	There are no (further) constraints on this element Element id CarePlan.activity.detail.location.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. 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. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..0	Identifier	There are no (further) constraints on this element Element id CarePlan.activity.detail.location.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments 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. 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 Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. 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). Data type Identifier Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: 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] servd: Identifier rim: .identifier
  display	Σ	0..0	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.location.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  performer	C	0..1	Reference(CareTeam | Device | HealthcareService | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)	There are no (further) constraints on this element Element id CarePlan.activity.detail.performer Short description Who will be responsible? Definition Identifies who's expected to be involved in the activity. Requirements Helps in planning of activity. Comments A performer MAY also be a participant in the care plan. Data type Reference(CareTeam | Device | HealthcareService | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.performer v2: PRT-5 : ( PRV-4 = (provider participations)); PRT-5 : ( PRV-4 = (non-provider person participations )) ; PRT-5 : ( PRV-4 = (patient non-subject of care) ) ; PRT-8 rim: .participation[typeCode=PFM]
  product[x]		1..1	CodeableConcept	Element id CarePlan.activity.detail.product[x] Short description The agent/antigen to be applied for special consideration. Definition Identifies the vaccine agent or antiger to apply special consideration for. Data type CodeableConcept Binding A product supplied or administered as part of a care plan activity. SNOMEDCTMedicationCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: RXE-2 / RXO-1 / RXD-2 rim: .participation[typeCode=PRD].role
  id		0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.product[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.activity.detail.product[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	1..1	Coding	Element id CarePlan.activity.detail.product[x].coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 1st instance Agent/Antigen in NVC code, 2nd instance Agent/Antigen in PIR code Data type Coding Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.product[x].coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.activity.detail.product[x].coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id CarePlan.activity.detail.product[x].coding.system Short description 1st instance Agent/Antigen in NVC code, 2nd instance Agent/Antigen in PIR code Definition 1st instance Agent/Antigen in NVC code, 2nd instance Agent/Antigen in PIR code Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem code-NVC: https://nvc-cnv.canada.ca code-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code
  version	Σ	0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.product[x].coding.version Short description Version of the system - if relevant Definition 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 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. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id CarePlan.activity.detail.product[x].coding.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Comments See Mappings Data type code Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code source-PIR-code-agent: BCYREPORTNG.RBCY_FN_GET_CONCEPT_CODE(sc.AGENT_CD_CNCPT_ID) source-PIR-code-antigen: BCYREPORTNG.RBCY_FN_GET_CONCEPT_CODE(SPECIAL_CONSIDERATION.ASIIS_VACC_CODE) source-PHSL-agent: agent source-PHSL-antigen: antigen
  display	Σ	1..1	string	Element id CarePlan.activity.detail.product[x].coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments See Mappings Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName source-PIR-code-agent: REPORTNG.GET_ITERM_DESC(sc.AGENT_CD_CNCPT_ID) source-PIR-code-antigen: REPORTNG.GET_ITERM_DESC(SPECIAL_CONSIDERATION.ASIIS_VACC_CODE) source-PHSL-agent: agentDescription source-PHSL-antigen: antigenDescription
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id CarePlan.activity.detail.product[x].coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.product[x].text Short description Plain text representation of the concept Definition 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. Requirements 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. Comments Very often the text is the same as a displayName of one of the codings. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  dailyAmount	C	0..1	SimpleQuantity	There are no (further) constraints on this element Element id CarePlan.activity.detail.dailyAmount Short description How to consume/day? Alternate names daily dose Definition Identifies the quantity expected to be consumed in a given day. Requirements Allows rough dose checking. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type SimpleQuantity Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) qty-3: If a code for the unit is present, the system SHALL also be present code.empty() or system.exists() sqty-1: The comparator is not used on a SimpleQuantity comparator.empty() Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values v2: RXO-23 / RXE-19 / RXD-12 rim: .outboundRelationship[typeCode=COMP][classCode=SBADM].doseQuantity
  quantity	C	0..1	SimpleQuantity	There are no (further) constraints on this element Element id CarePlan.activity.detail.quantity Short description How much to administer/supply/consume Definition Identifies the quantity expected to be supplied, administered or consumed by the subject. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type SimpleQuantity Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) qty-3: If a code for the unit is present, the system SHALL also be present code.empty() or system.exists() sqty-1: The comparator is not used on a SimpleQuantity comparator.empty() Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values v2: RXO-11 / RXE-10 / RXD-4 / RXG-5 / RXA-6 / TQ1-2.1 *and* RXO-12 / RXE-11 / RXD-5 / RXG-7 / RXA-7 / TQ1-2.2 rim: .outboundRelationship[typeCode=COMP][classCode=SPLY].quantity
  description		0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.description Short description Extra info describing activity to perform Definition This provides a textual description of constraints on the intended activity occurrence, including relation to other activities. It may also include objectives, pre-conditions and end-conditions. Finally, it may convey specifics about the activity such as body site, method, route, etc. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: NTE? rim: .text
  note		0..*	Annotation	Element id CarePlan.note Short description Comments about the special consideration Definition Comments about the special consideration Requirements Used to capture information that applies to the plan as a whole that doesn't fit into discrete elements. Comments Comments about the special consideration Data type Annotation Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act workflow: Request.note v2: NTE? rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value
  id		0..0	string	There are no (further) constraints on this element Element id CarePlan.note.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	C	2..*	Extension	There are no (further) constraints on this element Element id CarePlan.note.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRIdentifierExtension	C	1..1	Extension(string)	Element id CarePlan.note.extension:pIRIdentifierExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(string) Extension URL PIRIdentifierExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  pIRLockSeqNumberExtension	C	1..1	Extension(integer)	Element id CarePlan.note.extension:pIRLockSeqNumberExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(integer) Extension URL PIRLockSeqNumberExtension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  author[x]	Σ	0..0		There are no (further) constraints on this element Element id CarePlan.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Comments Organization is used when there's no need for specific attribution as to who made the comment. Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act.participant[typeCode=AUT].role
  time	Σ	0..1	dateTime	There are no (further) constraints on this element Element id CarePlan.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act.effectiveTime
  text	Σ	1..1	markdown	There are no (further) constraints on this element Element id CarePlan.note.text Short description The annotation - text content (as markdown) Definition The text of the annotation in markdown format. Comments Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/ Data type markdown Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Act.text