• 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()
• 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-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()
• dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
  contained.contained.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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label
  contained.meta.security.empty()
• dom-6: A resource should have narrative for robust management
  text.`div`.exists()

• rim: Entity. Role, or Act
• 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]

See Mappings

• source-PIR: SPECIAL_CONSIDERATION.CONTRA_ID
• source-PHSL: specialConsiderationId

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: n/a

Apply "2025.01.1". This indicates the FHIR Specs as of year Jan 2025.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

Updated: Relax the previously crossed-out elements.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

Apply "http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Condition"

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

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).

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: Act.text?

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.

• rim: N/A

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: N/A

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.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: N/A

Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers.

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• workflow: Event.identifier
• w5: FiveWs.identifier
• rim: .id

The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• workflow: Event.status
• w5: FiveWs.status
• sct-concept: < 303105007 |Disease phases|
• v2: PRB-14
• rim: Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="clinicalStatus", moodCode=EVN].value

verificationStatus is not required. For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status. The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• workflow: Event.status
• w5: FiveWs.status
• sct-concept: < 410514004 |Finding context value|
• v2: PRB-13
• rim: Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="verificationStatus", moodCode=EVN].value
• sct-attr: 408729009

The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• w5: FiveWs.class
• sct-concept: < 404684003 |Clinical finding|
• v2: 'problem' if from PRB-3. 'diagnosis' if from DG1 segment in PV1 message
• rim: .code

Coding of the severity with a terminology is preferred, where possible.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• w5: FiveWs.grade
• sct-concept: < 272141005 |Severities|
• v2: PRB-26 / ABS-3
• rim: Can be pre/post-coordinated into value. Or ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="severity"].value
• sct-attr: 246112005

0..1 to account for primarily narrative only resources.

Identification of the Special Consideration TYPE + REASON

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• workflow: Event.code
• w5: FiveWs.what[x]
• sct-concept: code 246090004 |Associated finding| (< 404684003 |Clinical finding| MINUS << 420134006 |Propensity to adverse reactions| MINUS << 473010000 |Hypersensitivity condition| MINUS << 79899007 |Drug interaction| MINUS << 69449002 |Drug action| MINUS << 441742003 |Evaluation finding| MINUS << 307824009 |Administrative status| MINUS << 385356007 |Tumor stage finding|) OR < 413350009 |Finding with explicit context| OR < 272379006 |Event|
• v2: PRB-3
• rim: .value
• sct-attr: 246090004

• rim: n/a

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: n/a

Allows for alternative encodings within a code system, and translations to other code systems.

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• v2: C*E.1-8, C*E.10-22
• rim: union(., ./translation)
• orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

Allows for alternative encodings within a code system, and translations to other code systems.

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• v2: C*E.1-8, C*E.10-22
• rim: union(., ./translation)
• orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

• rim: n/a

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: n/a

Need to be unambiguous about the source of the definition of the symbol.

See Mappings

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• 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

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• v2: C*E.7
• rim: ./codeSystemVersion
• orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

Need to refer to a particular code in the system.

Possible Value: CONTRAINDICATION | EXEMPTION | PRECAUTION

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• v2: C*E.1
• rim: ./code
• orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
• source-PIR: BCYREPORTNG.RBCY_FN_GET_CONCEPT_CODE(sc.AGENT_CD_CNCPT_ID)
• source-PHSL: scType

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

See Mappings

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• 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: "Type - " + REPORTNG.GET_ITERM_DESC(sc.AGENT_CD_CNCPT_ID) SPECIAL_CONSIDER_CD_CNCPT_ID)
• source-PHSL: scTypeDescription

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.

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• 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 ]

Allows for alternative encodings within a code system, and translations to other code systems.

PIR Special Consideration REASON

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• v2: C*E.1-8, C*E.10-22
• rim: union(., ./translation)
• orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

• rim: n/a

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: n/a

Need to be unambiguous about the source of the definition of the symbol.

See Mappings

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• 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

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• v2: C*E.7
• rim: ./codeSystemVersion
• orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

Need to refer to a particular code in the system.

Please refer to Special Consideration codeset value. See Mappings

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• v2: C*E.1
• rim: ./code
• orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
• source-PIR: BCYREPORTNG.RBCY_FN_GET_CONCEPT_CODE
• source-PHSL: scReasonCode

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Please refer to Special Consideration codeset DISPLAY value. See Mappings

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• 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: "Reason - " + BCYREPORTNG.RBCY_FN_GET_CONCEPT_CODE (SPECIAL_CONSIDERATION.CONTRA_CODE)
• source-PHSL: scReasonDescription

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.

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• 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 ]

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.

Required if Special Consideration Reason = "Other (specify)"

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• 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

Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• sct-concept: < 442083009 |Anatomical or acquired body structure|
• rim: .targetBodySiteCode
• sct-attr: 363698007

Group is typically used for veterinary or public health use cases.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• workflow: Event.subject
• w5: FiveWs.subject[x]
• v2: PID-3
• rim: .participation[typeCode=SBJ].role[classCode=PAT]
• w5: FiveWs.subject

• rim: n/a

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: n/a

See Mappings

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: N/A
• source-PIR: fullURL + "Patient/" + (Patient ID)

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: N/A

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).

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: .identifier

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: N/A

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. This record indicates the encounter this particular record is associated with. In the case of a "new" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first "known".

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• workflow: Event.context
• w5: FiveWs.context
• v2: PV1-19 (+PV1-54)
• rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]

Age is generally used when the patient reports an age at which the Condition began to occur.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• workflow: Event.occurrence[x]
• w5: FiveWs.init
• v2: PRB-16
• rim: .effectiveTime.low or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at onset"].value

There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated. If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid. When abatementString exists, it implies the condition is abated.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• w5: FiveWs.done[x]
• rim: .effectiveTime.high or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at remission"].value or .inboundRelationship[typeCode=SUBJ]source[classCode=CONC, moodCode=EVN].status=completed

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• w5: FiveWs.recorded
• v2: REL-11
• rim: .participation[typeCode=AUT].time

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• w5: FiveWs.author
• rim: .participation[typeCode=AUT].role

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• w5: FiveWs.source
• v2: REL-7.1 identifier + REL-7.12 type code
• rim: .participation[typeCode=INF].role

• con-1: Stage SHALL have summary or assessment
  summary.exists() or assessment.exists()
• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="stage/grade"]

• rim: n/a

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: n/a

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.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ext-1: Must have either extensions or value[x], not both
  extension.exists() != value.exists()

• rim: N/A

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• sct-concept: < 254291000 |Staging and scales|
• v2: PRB-14
• rim: .value

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: .self

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="stage type"]

The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.

• con-2: evidence SHALL have code or details
  code.exists() or detail.exists()
• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: .outboundRelationship[typeCode=SPRT].target[classCode=OBS, moodCode=EVN]

• rim: n/a