Copy of 'GP Connect Data Model | FHIR STU3 Representation'

Notice: This guidance is under active development by NHS England and content may be added or updated on a regular basis.

Profile: CareConnect-GPC-Composition-1

idΣ1..1id
id0..1string
extensionC0..*Extension
versionIdΣ0..1id
lastUpdatedΣ0..1instant
sourceΣ0..1uri
profileΣ1..*canonical(StructureDefinition)
securityΣ0..*CodingBinding
tagΣ0..*Coding
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
id0..1string
extensionC0..*Extension
url1..1uriFixed Value
valueAddressAddress
valueAgeAge
valueAnnotationAnnotation
valueAttachmentAttachment
valueBase64Binarybase64Binary
valueBooleanboolean
valueCanonicalcanonical
valueCodecode
valueCodeableConceptCodeableConcept
valueCodingCoding
valueContactDetailContactDetail
valueContactPointContactPoint
valueContributorContributor
valueCountCount
valueDataRequirementDataRequirement
valueDatedate
valueDateTimedateTime
valueDecimaldecimal
valueDistanceDistance
valueDosageDosage
valueDurationDuration
valueExpressionExpression
valueHumanNameHumanName
valueIdid
valueIdentifierIdentifier
valueInstantinstant
valueIntegerinteger
valueMarkdownmarkdown
valueMetaMeta
valueMoneyMoney
valueOidoid
valueParameterDefinitionParameterDefinition
valuePeriodPeriod
valuePositiveIntpositiveInt
valueQuantityQuantity
valueRangeRange
valueRatioRatio
valueReferenceReference
valueRelatedArtifactRelatedArtifact
valueSampledDataSampledData
valueSignatureSignature
valueStringstring
valueTimetime
valueTimingTiming
valueTriggerDefinitionTriggerDefinition
valueUnsignedIntunsignedInt
valueUriuri
valueUrlurl
valueUsageContextUsageContext
valueUuiduuid
modifierExtension?! C0..*Extension
id0..1string
extensionC0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ1..1uri
valueΣ1..1string
periodΣ C0..1Period
assignerΣ C0..1Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1)
id0..1string
extensionC0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ1..1uriFixed Value
valueΣ1..1string
periodΣ C0..1Period
assignerΣ C0..1Reference(CareConnect-GPC-Organization-1)
id0..1string
extensionC0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ1..1uri
valueΣ1..1string
periodΣ C0..1Period
assignerΣ C0..1Reference(CareConnect-GPC-Organization-1)
statusΣ ?!1..1codeBindingFixed Value
id0..1string
extensionC0..*Extension
id0..1string
extensionC0..*Extension
systemΣ1..1uriFixed Value
versionΣ0..0string
codeΣ1..1codeFixed Value
displayΣ1..1stringFixed Value
userSelectedΣ0..0boolean
textΣ0..1string
categoryΣ0..*CodeableConcept
subjectΣ C0..1Reference(CareConnect-GPC-Patient-1)
encounterΣ C1..1Reference(CareConnect-GPC-Encounter-1)
dateΣ1..1dateTime
authorΣ C1..*Reference(Device) | Reference(RelatedPerson) | Reference(CareConnect-GPC-Practitioner-1) | Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1)
titleΣ1..1string
confidentialityΣ0..0codeBinding
custodianΣ C0..0Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1)
id0..1string
id0..1string
extensionC0..*Extension
url1..1uriFixed Value
valueAddressAddress
valueAgeAge
valueAnnotationAnnotation
valueAttachmentAttachment
valueBase64Binarybase64Binary
valueBooleanboolean
valueCanonicalcanonical
valueCodecode
valueCodeableConceptCodeableConcept
valueCodingCoding
valueContactDetailContactDetail
valueContactPointContactPoint
valueContributorContributor
valueCountCount
valueDataRequirementDataRequirement
valueDatedate
valueDateTimedateTime
valueDecimaldecimal
valueDistanceDistance
valueDosageDosage
valueDurationDuration
valueExpressionExpression
valueHumanNameHumanName
valueIdid
valueIdentifierIdentifier
valueInstantinstant
valueIntegerinteger
valueMarkdownmarkdown
valueMetaMeta
valueMoneyMoney
valueOidoid
valueParameterDefinitionParameterDefinition
valuePeriodPeriod
valuePositiveIntpositiveInt
valueQuantityQuantity
valueRangeRange
valueRatioRatio
valueReferenceReference
valueRelatedArtifactRelatedArtifact
valueSampledDataSampledData
valueSignatureSignature
valueStringstring
valueTimetime
valueTimingTiming
valueTriggerDefinitionTriggerDefinition
valueUnsignedIntunsignedInt
valueUriuri
valueUrlurl
valueUsageContextUsageContext
valueUuiduuid
modifierExtensionΣ ?! C0..*Extension
title0..1string
id0..1string
extensionC0..*Extension
id0..1string
extensionC0..*Extension
systemΣ1..1uriFixed Value
versionΣ0..0string
codeΣ1..1codeFixed Value
displayΣ1..1stringFixed Value
userSelectedΣ0..0boolean
textΣ0..1string
authorC0..*Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
focusC0..1Reference(Resource)
textC0..1Narrative
mode1..1codeBindingFixed Value
id0..1string
extensionC0..*Extension
id0..1string
extensionC0..*Extension
systemΣ1..1uriFixed Value
versionΣ0..0string
codeΣ0..1code
displayΣ0..1string
userSelectedΣ0..0boolean
textΣ0..1string
entryC0..*Reference(CareConnect-GPC-Observation-1) | Reference(CareConnect-GPC-AllergyIntolerance-1) | Reference(CareConnect-GPC-MedicationRequest-1) | Reference(http://hl7.org/fhir/StructureDefinition/ReferralRequest)
emptyReasonC0..0CodeableConceptBinding
sectionC0..*see (section)
CompositionC
ShortA set of resources composed into a single coherent clinical statement with clinical attestation
Definition

A set of healthcare-related information that is assembled together into a single logical package that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle where Bundle.type=document, and any other resources referenced from Composition must be included as subsequent entries in the Bundle (for example Patient, Practitioner, Encounter, etc.).

Cardinality0..*
Comments

While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

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
  • rim: Document[classCode="DOC" and moodCode="EVN" and isNormalAct()]
  • cda: ClinicalDocument
  • fhirdocumentreference: when described by DocumentReference
Composition.idΣ
ShortLogical 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.

Cardinality1..1
Typeid
SummaryTrue
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Composition.metaΣ
ShortMetadata 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.

Cardinality0..1
TypeMeta
SummaryTrue
ConditionsThe cardinality or value of this element may be affected by these constraints: 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
Composition.meta.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Composition.meta.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.meta.versionIdΣ
ShortVersion 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.

Cardinality0..1
Typeid
SummaryTrue
Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Composition.meta.lastUpdatedΣ
ShortWhen the resource version last changed
Definition

When the resource last changed - e.g. when the version changed.

Cardinality0..1
Typeinstant
SummaryTrue
Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Composition.meta.sourceΣ
ShortIdentifies 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.

Cardinality0..1
Typeuri
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Composition.meta.profileΣ
ShortProfiles 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.

Cardinality1..*
Typecanonical(StructureDefinition)
SummaryTrue
Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Composition.meta.securityΣ
ShortSecurity Labels applied to this resource
Definition

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

Cardinality0..*
TypeCoding
Binding

Security Labels from the Healthcare Privacy and Security Classification System.

AllSecurityLabels (extensible)

SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
Composition.meta.tagΣ
ShortTags 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.

Cardinality0..*
TypeCoding
Binding

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

CommonTags (example)

SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
Composition.implicitRulesΣ ?!
ShortA 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.

Cardinality0..1
Typeuri
ModifierTrue
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Composition.language
ShortLanguage of the resource content
Definition

The base language in which the resource is written.

Cardinality0..1
Typecode
Binding

A human language.

CommonLanguages (preferred)

Binding extensions
MaxValueSetAllLanguages
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).

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Composition.text
ShortText summary of the resource, for human interpretation
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Cardinality0..1
TypeNarrative
Aliasnarrative, html, xhtml, display
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: 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?
Composition.contained
ShortContained, inline 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.

Cardinality0..*
TypeResource
Aliasinline resources, anonymous resources, contained resources
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.

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
Composition.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.extension:careSettingTypeExtensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and 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.

Cardinality0..1
TypeExtension
Aliasextensions, user content
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.extension:careSettingTypeExtension.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Composition.extension:careSettingTypeExtension.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.extension:careSettingTypeExtension.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
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.

Fixed Value
https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-CareSettingType-1
Mappings
  • rim: N/A
Composition.extension:careSettingTypeExtension.value[x]
ShortValue of extension
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..1
TypeAddress | Age | Annotation | Attachment | base64Binary | boolean | canonical | code | CodeableConcept | Coding | ContactDetail | ContactPoint | Contributor | Count | DataRequirement | date | dateTime | decimal | Distance | Dosage | Duration | Expression | HumanName | id | Identifier | instant | integer | markdown | Meta | Money | oid | ParameterDefinition | Period | positiveInt | Quantity | Range | Ratio | Reference | RelatedArtifact | SampledData | Signature | string | time | Timing | TriggerDefinition | unsignedInt | uri | url | UsageContext | uuid
ConditionsThe cardinality or value of this element may be affected by these constraints: 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
Composition.modifierExtension?! C
ShortExtensions that cannot be ignored
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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).

Cardinality0..*
TypeExtension
ModifierTrue
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.identifierΣ
ShortVersion-independent identifier for the Composition
Definition

A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

Cardinality0..1
TypeIdentifier
SummaryTrue
Comments

Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

Slicing

Unordered, Open, by system(Value)

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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: Document.id / Document.setId
  • cda: .setId
  • fhirdocumentreference: DocumentReference.masterIdentifier
Composition.identifier.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Composition.identifier.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.identifier.useΣ ?!
Shortusual | official | temp | secondary | old (If known)
Definition

The purpose of this identifier.

Cardinality0..1
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
Composition.identifier.typeΣ
ShortDescription of identifier
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality0..1
TypeCodeableConcept
Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

IdentifierTypeCodes (extensible)

SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
Composition.identifier.systemΣ
ShortThe namespace for the identifier value
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality1..1
Typeuri
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
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
Composition.identifier.valueΣ
ShortThe 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.

Cardinality1..1
Typestring
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
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
Composition.identifier.periodΣ C
ShortTime period when id is/was valid for use
Definition

Time period during which identifier is/was valid for use.

Cardinality0..1
TypePeriod
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be 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
Composition.identifier.assignerΣ C
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality0..1
TypeReference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1)
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be 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
Composition.identifier:crossCareSettingIdentifierΣ
ShortVersion-independent identifier for the Composition
Definition

A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

Cardinality1..1
TypeIdentifier
SummaryTrue
Comments

Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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: Document.id / Document.setId
  • cda: .setId
  • fhirdocumentreference: DocumentReference.masterIdentifier
Composition.identifier:crossCareSettingIdentifier.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Composition.identifier:crossCareSettingIdentifier.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.identifier:crossCareSettingIdentifier.useΣ ?!
Shortusual | official | temp | secondary | old (If known)
Definition

The purpose of this identifier.

Cardinality0..1
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
Composition.identifier:crossCareSettingIdentifier.typeΣ
ShortDescription of identifier
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality0..1
TypeCodeableConcept
Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

IdentifierTypeCodes (extensible)

SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
Composition.identifier:crossCareSettingIdentifier.systemΣ
ShortThe namespace for the identifier value
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality1..1
Typeuri
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be 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
https://fhir.nhs.uk/Id/cross-care-setting-identifier
ExamplesGeneral
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
Composition.identifier:crossCareSettingIdentifier.valueΣ
ShortThe 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.

Cardinality1..1
Typestring
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
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
Composition.identifier:crossCareSettingIdentifier.periodΣ C
ShortTime period when id is/was valid for use
Definition

Time period during which identifier is/was valid for use.

Cardinality0..1
TypePeriod
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be 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
Composition.identifier:crossCareSettingIdentifier.assignerΣ C
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality0..1
TypeReference(CareConnect-GPC-Organization-1)
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be 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
Composition.identifier:identifierΣ
ShortVersion-independent identifier for the Composition
Definition

A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

Cardinality0..1
TypeIdentifier
SummaryTrue
Comments

Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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: Document.id / Document.setId
  • cda: .setId
  • fhirdocumentreference: DocumentReference.masterIdentifier
Composition.identifier:identifier.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Composition.identifier:identifier.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.identifier:identifier.useΣ ?!
Shortusual | official | temp | secondary | old (If known)
Definition

The purpose of this identifier.

Cardinality0..1
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
Composition.identifier:identifier.typeΣ
ShortDescription of identifier
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality0..1
TypeCodeableConcept
Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

IdentifierTypeCodes (extensible)

SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
Composition.identifier:identifier.systemΣ
ShortThe namespace for the identifier value
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality1..1
Typeuri
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
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
Composition.identifier:identifier.valueΣ
ShortThe 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.

Cardinality1..1
Typestring
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
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
Composition.identifier:identifier.periodΣ C
ShortTime period when id is/was valid for use
Definition

Time period during which identifier is/was valid for use.

Cardinality0..1
TypePeriod
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be 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
Composition.identifier:identifier.assignerΣ C
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality0..1
TypeReference(CareConnect-GPC-Organization-1)
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be 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
Composition.statusΣ ?!
Shortpreliminary | final | amended | entered-in-error
Definition

The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

Cardinality1..1
Typecode
Binding

The workflow/clinical status of the composition.

CompositionStatus (required)

ModifierTrue
SummaryTrue
Requirements

Need to be able to mark interim, amended, or withdrawn compositions or documents.

Comments

If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements.

Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.

ConditionsThe cardinality or value of this element may be 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
final
Mappings
  • rim: n/a
  • workflow: Event.status
  • w5: FiveWs.status
  • rim: interim: .completionCode="IN" & ./statusCode[isNormalDatatype()]="active"; final: .completionCode="AU" && ./statusCode[isNormalDatatype()]="complete" and not(./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[subsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("ReviseComposition", code) and isNormalAct()]); amended: .completionCode="AU" && ./statusCode[isNormalDatatype()]="complete" and ./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[subsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("ReviseComposition", code) and isNormalAct() and statusCode="completed"]; withdrawn : .completionCode=NI && ./statusCode[isNormalDatatype()]="obsolete"
  • cda: n/a
  • fhirdocumentreference: DocumentReference.status
Composition.typeΣ
ShortKind of composition (SNOMED CT)
Definition

Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.

Cardinality1..1
TypeCodeableConcept
Binding

SNOMED CT Document Type

FHIRDocumentTypeCodes (preferred)

SummaryTrue
Requirements

Key metadata element describing the composition, used in searching/filtering.

Comments

For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
  • rim: ./code
  • cda: .code
  • fhirdocumentreference: DocumentReference.type
Composition.type.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Composition.type.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.type.codingΣ
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality1..*
TypeCoding
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
Composition.type.coding.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Composition.type.coding.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.type.coding.systemΣ
ShortIdentity of the terminology system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality1..1
Typeuri
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be 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://snomed.info/sct
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Composition.type.coding.versionΣ
ShortVersion 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.

Cardinality0..0
Typestring
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
Composition.type.coding.codeΣ
ShortSymbol 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).

Cardinality1..1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be 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
325851000000107
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Composition.type.coding.displayΣ
ShortRepresentation defined by the system
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality1..1
Typestring
SummaryTrue
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

ConditionsThe cardinality or value of this element may be 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
Consultation
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
Composition.type.coding.userSelectedΣ
ShortIf 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).

Cardinality0..0
Typeboolean
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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 ]
Composition.type.textΣ
ShortPlain 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.

Cardinality0..1
Typestring
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
Composition.categoryΣ
ShortCategorization of Composition
Definition

A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.

Cardinality0..*
TypeCodeableConcept
Binding

High-level kind of a clinical document at a macro level.

DocumentClassValueSet (example)

SummaryTrue
Requirements

Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.

Comments

This is a metadata field from XDS/MHD.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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.subject
  • w5: FiveWs.class
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
  • cda: n/a
  • fhirdocumentreference: DocumenttReference.category
Composition.subjectΣ C
ShortWho and/or what the composition is about
Definition

Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).

Cardinality0..1
TypeReference(CareConnect-GPC-Patient-1)
SummaryTrue
Requirements

Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.

Comments

For clinical documents, this is usually the patient.

ConditionsThe cardinality or value of this element may be 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]
  • rim: .participation[typeCode="SBJ"].role[typeCode="PAT"]
  • cda: .recordTarget
  • fhirdocumentreference: DocumentReference.subject
  • w5: FiveWs.subject
Composition.encounterΣ C
ShortContext of the Composition
Definition

Describes the clinical encounter or type of care this documentation is associated with.

Cardinality1..1
TypeReference(CareConnect-GPC-Encounter-1)
SummaryTrue
Requirements

Provides context for the composition and supports searching.

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.

ConditionsThe cardinality or value of this element may be 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
  • rim: unique(highest(./outboundRelationship[typeCode="SUBJ" and isNormalActRelationship()], priorityNumber)/target[moodCode="EVN" and classCode=("ENC", "PCPR") and isNormalAct])
  • cda: .componentOf.encompassingEncounter
  • fhirdocumentreference: DocumentReference.context.encounter
Composition.dateΣ
ShortComposition editing time
Definition

The composition editing time, when the composition was last logically changed by the author.

Cardinality1..1
TypedateTime
SummaryTrue
Requirements

dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.

Comments

The Last Modified Date on the composition may be after the date of the document was attested without being changed.

ConditionsThe cardinality or value of this element may be affected by these constraints: 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[type="TS"]
  • cda: .effectiveTime
  • fhirdocumentreference: DocumentReference.content.attachment.date, DocumentReference.created
Composition.authorΣ C
ShortWho and/or what authored the composition
Definition

Identifies who is responsible for the information in the composition, not necessarily who typed it in.

Cardinality1..*
TypeReference(Device) | Reference(RelatedPerson) | Reference(CareConnect-GPC-Practitioner-1) | Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1)
SummaryTrue
Requirements

Identifies who is responsible for the content.

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.

ConditionsThe cardinality or value of this element may be 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.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
  • fhirdocumentreference: DocumentReference.agent
Composition.titleΣ
ShortHuman Readable name/title
Definition

Official human-readable label for the composition.

Cardinality1..1
Typestring
SummaryTrue
Comments

For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.

ConditionsThe cardinality or value of this element may be affected by these constraints: 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: ./title
  • cda: .title
  • fhirdocumentreference: DocumentReference.description, DocumentReference.content.attachment.title
Composition.confidentialityΣ
ShortAs defined by affinity domain
Definition

The code specifying the level of confidentiality of the Composition.

Cardinality0..0
Typecode
Binding

Codes specifying the level of confidentiality of the composition.

v3.ConfidentialityClassification (required)

SummaryTrue
Comments

The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.

ConditionsThe cardinality or value of this element may be affected by these constraints: 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: .confidentialityCode
  • cda: .confidentialityCode
  • fhirdocumentreference: DocumentReference.securityLabel
Composition.attester
ShortAttests to accuracy of composition
Definition

A participant who has attested to the accuracy of the composition/document.

Cardinality0..0
TypeBackboneElement
Requirements

Identifies responsibility for the accuracy of the composition content.

Comments

Only list each attester once.

ConditionsThe cardinality or value of this element may be affected by these constraints: 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="AUTHEN"].role[classCode="ASSIGNED"]
  • cda: .authenticator/.legalAuthenticator
  • fhirdocumentreference: DocumentReference.authenticator
Composition.attester.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Composition.attester.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.attester.modifierExtensionΣ ?! C
ShortExtensions that cannot be ignored even if unrecognized
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.attester.mode
Shortpersonal | professional | legal | official
Definition

The type of attestation the authenticator offers.

Cardinality1..1
Typecode
Binding

The way in which a person authenticated a composition.

CompositionAttestationMode (required)

Requirements

Indicates the level of authority of the attestation.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: 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: unique(./modeCode)
  • cda: implied by .authenticator/.legalAuthenticator
Composition.attester.time
ShortWhen the composition was attested
Definition

When the composition was attested by the party.

Cardinality0..1
TypedateTime
Requirements

Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

ConditionsThe cardinality or value of this element may be affected by these constraints: 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: ./time[type="TS" and isNormalDatatype()]
  • cda: .authenticator.time
Composition.attester.partyC
ShortWho attested the composition
Definition

Who attested the composition in the specified way.

Cardinality0..1
TypeReference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1) | Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Practitioner-1) | Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1)
Requirements

Identifies who has taken on the responsibility for accuracy of the composition content.

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.

ConditionsThe cardinality or value of this element may be 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
  • rim: ./role[classCode="ASSIGNED" and isNormalRole]/player[determinerCode="INST" and classCode=("DEV", "PSN") and isNormalEntity()] or ./role[classCode="ASSIGNED" and isNormalRole and not(player)]/scoper[determinerCode="INST" and classCode="ORG" and isNormalEntity()]
  • cda: .authenticator.assignedEnttty
Composition.custodianΣ C
ShortOrganization which maintains the composition
Definition

Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.

Cardinality0..0
TypeReference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1)
SummaryTrue
Requirements

Identifies where to go to find the current version, where to report issues, etc.

Comments

This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.

ConditionsThe cardinality or value of this element may be 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: .participation[typeCode="RCV"].role[classCode="CUST"].scoper[classCode="ORG" and determinerCode="INST"]
  • cda: .custodian.assignedCustodian
  • fhirdocumentreference: DocumentReference.custodian
Composition.relatesTo
ShortRelationships to other compositions/documents
Definition

Relationships that this composition has with other compositions or documents that already exist.

Cardinality0..0
TypeBackboneElement
Comments

A document is a version specific composition.

ConditionsThe cardinality or value of this element may be affected by these constraints: 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
  • cda: .relatedDocument
  • fhirdocumentreference: DocumentReference.relatesTo
Composition.relatesTo.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Composition.relatesTo.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.relatesTo.modifierExtensionΣ ?! C
ShortExtensions that cannot be ignored even if unrecognized
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.relatesTo.code
Shortreplaces | transforms | signs | appends
Definition

The type of relationship that this composition has with anther composition or document.

Cardinality1..1
Typecode
Binding

The type of relationship between documents.

DocumentRelationshipType (required)

Comments

If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.

ConditionsThe cardinality or value of this element may be affected by these constraints: 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
  • cda: .relatedDocument.typeCode
  • fhirdocumentreference: DocumentReference.relatesTo.code
Composition.relatesTo.target[x]
ShortTarget of the relationship
Definition

The target composition/document of this relationship.

Cardinality1..1
TypeIdentifier | Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Composition-1)
ConditionsThe cardinality or value of this element may be affected by these constraints: 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: .target[classCode="DOC", moodCode="EVN"].id
  • cda: .relatedDocument.id
  • fhirdocumentreference: DocumentReference.relatesTo.target
Composition.eventΣ
ShortThe clinical service(s) being documented
Definition

The clinical service, such as a colonoscopy or an appendectomy, being documented.

Cardinality0..0
TypeBackboneElement
SummaryTrue
Requirements

Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

Comments

The event needs to be consistent with the type element, though can provide further information if desired.

ConditionsThe cardinality or value of this element may be affected by these constraints: 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="SUBJ"].target[classCode<'ACT']
  • cda: .documentationOf.serviceEvent
  • fhirdocumentreference: DocumentReference.event
Composition.event.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Composition.event.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.event.modifierExtensionΣ ?! C
ShortExtensions that cannot be ignored even if unrecognized
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.event.codeΣ
ShortCode(s) that apply to the event being documented
Definition

This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.

Cardinality0..*
TypeCodeableConcept
Binding

This list of codes represents the main clinical acts being documented.

ActCode (example)

SummaryTrue
Comments

An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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: .code
  • cda: .code
  • fhirdocumentreference: DocumentReference.event.code
Composition.event.periodΣ C
ShortThe period covered by the documentation
Definition

The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.

Cardinality0..1
TypePeriod
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be 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: .effectiveTime
  • fhirdocumentreference: DocumentReference.event.period
Composition.event.detailΣ C
ShortThe event(s) being documented
Definition

The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.

Cardinality0..*
TypeReference(Resource)
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be 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
  • cda: n/a
Composition.sectionC
ShortComposition is broken into sections
Definition

The root of the sections that make up the composition.

Cardinality1..*
TypeBackboneElement
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
Mappings
  • rim: n/a
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
Composition.section.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Composition.section.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.section.extension:problemReferenceC
ShortAn extension to allow resolution of problem link to composition section.
Definition

An extension to allow resolution of the problem link to composition section - will be back reference to problem id … nb this is in the 1st instance intended to be used to resolve the problem reference e.g. problem references composition and consumer must then look for the section with the id that corresponds to the problem to make the linkage

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.section.extension:problemReference.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Composition.section.extension:problemReference.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.section.extension:problemReference.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
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.

Fixed Value
http://hl7.org/fhir/STU3/extension-valueset-reference.html
Mappings
  • rim: N/A
Composition.section.extension:problemReference.value[x]
ShortValue of extension
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..1
TypeAddress | Age | Annotation | Attachment | base64Binary | boolean | canonical | code | CodeableConcept | Coding | ContactDetail | ContactPoint | Contributor | Count | DataRequirement | date | dateTime | decimal | Distance | Dosage | Duration | Expression | HumanName | id | Identifier | instant | integer | markdown | Meta | Money | oid | ParameterDefinition | Period | positiveInt | Quantity | Range | Ratio | Reference | RelatedArtifact | SampledData | Signature | string | time | Timing | TriggerDefinition | unsignedInt | uri | url | UsageContext | uuid
ConditionsThe cardinality or value of this element may be affected by these constraints: 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
Composition.section.modifierExtensionΣ ?! C
ShortExtensions that cannot be ignored even if unrecognized
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.section.title
ShortLabel for section (e.g. for ToC)
Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Cardinality0..1
Typestring
Aliasheader, label, caption
Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

ConditionsThe cardinality or value of this element may be affected by these constraints: 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: ./title
  • cda: .title
Composition.section.code
ShortClassification of section (recommended)
Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

Cardinality1..1
TypeCodeableConcept
Binding

Classification of a section of a composition/document.

DocumentSectionCodes (preferred)

Requirements

Provides computable standardized labels to topics within the document.

Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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: ./code
  • cda: .code
Composition.section.code.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Composition.section.code.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.section.code.codingΣ
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality1..*
TypeCoding
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
Composition.section.code.coding.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Composition.section.code.coding.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.section.code.coding.systemΣ
ShortIdentity of the terminology system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality1..1
Typeuri
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be 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://snomed.info/sct
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Composition.section.code.coding.versionΣ
ShortVersion 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.

Cardinality0..0
Typestring
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
Composition.section.code.coding.codeΣ
ShortSymbol 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).

Cardinality1..1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be 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
25851000000105
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Composition.section.code.coding.displayΣ
ShortRepresentation defined by the system
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality1..1
Typestring
SummaryTrue
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

ConditionsThe cardinality or value of this element may be 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
Topic (EHR)
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
Composition.section.code.coding.userSelectedΣ
ShortIf 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).

Cardinality0..0
Typeboolean
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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 ]
Composition.section.code.textΣ
ShortPlain 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.

Cardinality0..1
Typestring
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
Composition.section.authorC
ShortWho and/or what authored the section
Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Cardinality0..*
TypeReference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
Requirements

Identifies who is responsible for the content.

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.

ConditionsThe cardinality or value of this element may be 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
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
Composition.section.focusC
ShortWho/what the section is about, when it is not about the subject of composition
Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Cardinality0..1
TypeReference(Resource)
Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

ConditionsThe cardinality or value of this element may be 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)
  • cda: .subject? (CDA did not differentiate between subject and focus)
Composition.section.textC
ShortText summary of the section, for human interpretation
Definition

A human-readable narrative that contains the attested content of the section, 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.

Cardinality0..1
TypeNarrative
Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, cmp-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: .text
  • cda: .text
Composition.section.mode
Shortworking | snapshot | changes
Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Cardinality1..1
Typecode
Binding

The processing mode that applies to this section.

ListMode (required)

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

ConditionsThe cardinality or value of this element may be 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
snapshot
Mappings
  • rim: n/a
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
Composition.section.orderedBy
ShortOrder of section entries
Definition

Specifies the order applied to the items in the section entries.

Cardinality1..1
TypeCodeableConcept
Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
Composition.section.orderedBy.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Composition.section.orderedBy.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.section.orderedBy.codingΣ
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..*
TypeCoding
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
Composition.section.orderedBy.coding.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Composition.section.orderedBy.coding.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Composition.section.orderedBy.coding.systemΣ
ShortIdentity of the terminology system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality1..1
Typeuri
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be 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://hl7.org/fhir/ValueSet/list-order
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Composition.section.orderedBy.coding.versionΣ
ShortVersion 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.

Cardinality0..0
Typestring
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
Composition.section.orderedBy.coding.codeΣ
ShortSymbol 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).

Cardinality0..1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
Composition.section.orderedBy.coding.displayΣ
ShortRepresentation defined by the system
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality0..1
Typestring
SummaryTrue
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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
Composition.section.orderedBy.coding.userSelectedΣ
ShortIf 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).

Cardinality0..0
Typeboolean
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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 ]
Composition.section.orderedBy.textΣ
ShortPlain 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.

Cardinality0..1
Typestring
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-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
Composition.section.entryC
ShortA reference to data that supports this section
Definition

A reference to the actual resource from which the narrative in the section is derived.

Cardinality0..*
TypeReference(CareConnect-GPC-Observation-1) | Reference(CareConnect-GPC-AllergyIntolerance-1) | Reference(CareConnect-GPC-MedicationRequest-1) | Reference(http://hl7.org/fhir/StructureDefinition/ReferralRequest)
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, cmp-2
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=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
Composition.section.emptyReasonC
ShortWhy the section is empty
Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Cardinality0..0
TypeCodeableConcept
Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, cmp-2
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: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
Composition.section.sectionC
ShortNested Section
Definition

A nested sub-section within this section.

Cardinality0..*
Typesee (section)
Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

ConditionsThe cardinality or value of this element may be affected by these constraints: cmp-1
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
<StructureDefinition xmlns="http://hl7.org/fhir">
<lastUpdated value="2026-10-29T16:51:27.2013534+00:00" />
</meta>
<url value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Composition-1" />
<version value="1.1.0" />
<name value="CareConnect-GPC-Composition-1" />
<status value="draft" />
<date value="2019-08-28" />
<publisher value="HL7 UK" />
<name value="INTEROPen" />
<system value="email" />
<value value="admin@interopen.org" />
<use value="work" />
</telecom>
</contact>
<description value="A set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement." />
<purpose value="CURATED BY INTEROPen see: http://www.interopen.org/careconnect-curation-methodology/" />
<copyright value="Copyright © 2019 HL7 UK\n\nLicensed under the Apache License, Version 2.0 (the "License"); you may not use this file except in compliance with the License. You may obtain a copy of the License at\n\nhttp://www.apache.org/licenses/LICENSE-2.0\n\nUnless required by applicable law or agreed to in writing, software distributed under the License is distributed on an "AS IS" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License.\n\nHL7® FHIR® standard Copyright © 2011+ HL7\n\nThe HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at\n\nhttps://www.hl7.org/fhir/license.html" />
<fhirVersion value="3.0.2" />
<kind value="resource" />
<abstract value="false" />
<type value="Composition" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Composition" />
<derivation value="constraint" />
<element id="Composition.id">
<path value="Composition.id" />
<min value="1" />
</element>
<element id="Composition.meta">
<path value="Composition.meta" />
</element>
<element id="Composition.meta.profile">
<path value="Composition.meta.profile" />
<min value="1" />
</element>
<element id="Composition.extension:careSettingTypeExtension">
<path value="Composition.extension" />
<sliceName value="careSettingTypeExtension" />
<max value="1" />
<code value="Extension" />
<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-CareSettingType-1" />
</type>
</element>
<element id="Composition.extension:careSettingTypeExtension.url">
<path value="Composition.extension.url" />
<fixedUri value="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-CareSettingType-1" />
</element>
<element id="Composition.identifier">
<path value="Composition.identifier" />
<type value="value" />
<path value="system" />
</discriminator>
<rules value="open" />
</slicing>
</element>
<element id="Composition.identifier.system">
<path value="Composition.identifier.system" />
<min value="1" />
</element>
<element id="Composition.identifier.value">
<path value="Composition.identifier.value" />
<min value="1" />
</element>
<element id="Composition.identifier.assigner">
<path value="Composition.identifier.assigner" />
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1" />
</type>
</element>
<element id="Composition.identifier:crossCareSettingIdentifier">
<path value="Composition.identifier" />
<sliceName value="crossCareSettingIdentifier" />
<min value="1" />
</element>
<element id="Composition.identifier:crossCareSettingIdentifier.system">
<path value="Composition.identifier.system" />
<min value="1" />
<fixedUri value="https://fhir.nhs.uk/Id/cross-care-setting-identifier" />
</element>
<element id="Composition.identifier:crossCareSettingIdentifier.value">
<path value="Composition.identifier.value" />
<min value="1" />
</element>
<element id="Composition.identifier:crossCareSettingIdentifier.assigner">
<path value="Composition.identifier.assigner" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-1" />
</type>
</element>
<element id="Composition.identifier:identifier">
<path value="Composition.identifier" />
<sliceName value="identifier" />
</element>
<element id="Composition.identifier:identifier.assigner">
<path value="Composition.identifier.assigner" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-1" />
</type>
</element>
<element id="Composition.status">
<path value="Composition.status" />
<fixedCode value="final" />
</element>
<element id="Composition.type">
<path value="Composition.type" />
<short value="Kind of composition (SNOMED CT)" />
<strength value="preferred" />
<description value="SNOMED CT Document Type" />
</binding>
</element>
<element id="Composition.type.coding">
<path value="Composition.type.coding" />
<min value="1" />
</element>
<element id="Composition.type.coding.system">
<path value="Composition.type.coding.system" />
<min value="1" />
<fixedUri value="http://snomed.info/sct" />
</element>
<element id="Composition.type.coding.version">
<path value="Composition.type.coding.version" />
<max value="0" />
</element>
<element id="Composition.type.coding.code">
<path value="Composition.type.coding.code" />
<min value="1" />
<fixedCode value="325851000000107" />
</element>
<element id="Composition.type.coding.display">
<path value="Composition.type.coding.display" />
<min value="1" />
<fixedString value="Consultation" />
</element>
<element id="Composition.type.coding.userSelected">
<path value="Composition.type.coding.userSelected" />
<max value="0" />
</element>
<element id="Composition.subject">
<path value="Composition.subject" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
</type>
</element>
<element id="Composition.encounter">
<path value="Composition.encounter" />
<min value="1" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Encounter-1" />
</type>
</element>
<element id="Composition.author">
<path value="Composition.author" />
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
</type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1" />
</type>
</element>
<element id="Composition.confidentiality">
<path value="Composition.confidentiality" />
<max value="0" />
</element>
<element id="Composition.attester">
<path value="Composition.attester" />
<max value="0" />
</element>
<element id="Composition.attester.party">
<path value="Composition.attester.party" />
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Practitioner-1" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1" />
</type>
</element>
<element id="Composition.custodian">
<path value="Composition.custodian" />
<max value="0" />
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1" />
</type>
</element>
<element id="Composition.relatesTo">
<path value="Composition.relatesTo" />
<max value="0" />
</element>
<element id="Composition.relatesTo.target[x]">
<path value="Composition.relatesTo.target[x]" />
<code value="Identifier" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Composition-1" />
</type>
</element>
<element id="Composition.event">
<path value="Composition.event" />
<max value="0" />
</element>
<element id="Composition.section">
<path value="Composition.section" />
<min value="1" />
</element>
<element id="Composition.section.extension:problemReference">
<path value="Composition.section.extension" />
<sliceName value="problemReference" />
<short value="An extension to allow resolution of problem link to composition section." />
<definition value="An extension to allow resolution of the problem link to composition section - will be back reference to problem id … nb this is in the 1st instance intended to be used to resolve the problem reference e.g. problem references composition and consumer must then look for the section with the id that corresponds to the problem to make the linkage" />
<code value="Extension" />
<profile value="http://hl7.org/fhir/STU3/extension-valueset-reference.html" />
</type>
</element>
<element id="Composition.section.extension:problemReference.url">
<path value="Composition.section.extension.url" />
<fixedUri value="http://hl7.org/fhir/STU3/extension-valueset-reference.html" />
</element>
<element id="Composition.section.code">
<path value="Composition.section.code" />
<min value="1" />
<strength value="preferred" />
</binding>
</element>
<element id="Composition.section.code.coding">
<path value="Composition.section.code.coding" />
<min value="1" />
</element>
<element id="Composition.section.code.coding.system">
<path value="Composition.section.code.coding.system" />
<min value="1" />
<fixedUri value="http://snomed.info/sct" />
</element>
<element id="Composition.section.code.coding.version">
<path value="Composition.section.code.coding.version" />
<max value="0" />
</element>
<element id="Composition.section.code.coding.code">
<path value="Composition.section.code.coding.code" />
<min value="1" />
<fixedCode value="25851000000105" />
</element>
<element id="Composition.section.code.coding.display">
<path value="Composition.section.code.coding.display" />
<min value="1" />
<fixedString value="Topic (EHR)" />
</element>
<element id="Composition.section.code.coding.userSelected">
<path value="Composition.section.code.coding.userSelected" />
<max value="0" />
</element>
<element id="Composition.section.mode">
<path value="Composition.section.mode" />
<min value="1" />
<fixedCode value="snapshot" />
</element>
<element id="Composition.section.orderedBy">
<path value="Composition.section.orderedBy" />
<min value="1" />
</element>
<element id="Composition.section.orderedBy.coding.system">
<path value="Composition.section.orderedBy.coding.system" />
<min value="1" />
<fixedUri value="http://hl7.org/fhir/ValueSet/list-order" />
</element>
<element id="Composition.section.orderedBy.coding.version">
<path value="Composition.section.orderedBy.coding.version" />
<max value="0" />
</element>
<element id="Composition.section.orderedBy.coding.userSelected">
<path value="Composition.section.orderedBy.coding.userSelected" />
<max value="0" />
</element>
<element id="Composition.section.entry">
<path value="Composition.section.entry" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Observation-1" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-AllergyIntolerance-1" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationRequest-1" />
</type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ReferralRequest" />
</type>
</element>
<element id="Composition.section.emptyReason">
<path value="Composition.section.emptyReason" />
<max value="0" />
</element>
</differential>
</StructureDefinition>
{
"resourceType": "StructureDefinition",
"meta": {
"lastUpdated": "2026-10-29T16:51:27.2013534+00:00"
},
"url": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Composition-1",
"version": "1.1.0",
"name": "CareConnect-GPC-Composition-1",
"status": "draft",
"date": "2019-08-28",
"publisher": "HL7 UK",
"contact": [
{
"name": "INTEROPen",
"telecom": [
{
"system": "email",
"value": "admin@interopen.org",
"use": "work"
}
]
}
],
"description": "A set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement.",
"purpose": "CURATED BY INTEROPen see: http://www.interopen.org/careconnect-curation-methodology/",
"copyright": "Copyright © 2019 HL7 UK\n\nLicensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at\n\nhttp://www.apache.org/licenses/LICENSE-2.0\n\nUnless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License.\n\nHL7® FHIR® standard Copyright © 2011+ HL7\n\nThe HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at\n\nhttps://www.hl7.org/fhir/license.html",
"fhirVersion": "3.0.2",
"kind": "resource",
"abstract": false,
"type": "Composition",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Composition",
"derivation": "constraint",
"element": [
{
"id": "Composition.id",
"path": "Composition.id",
"min": 1
},
{
"id": "Composition.meta",
"path": "Composition.meta"
},
{
"id": "Composition.meta.profile",
"path": "Composition.meta.profile",
"min": 1
},
{
"id": "Composition.extension:careSettingTypeExtension",
"path": "Composition.extension",
"sliceName": "careSettingTypeExtension",
"max": "1",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-CareSettingType-1"
]
}
]
},
{
"id": "Composition.extension:careSettingTypeExtension.url",
"path": "Composition.extension.url",
"fixedUri": "https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-CareSettingType-1"
},
{
"id": "Composition.identifier",
"path": "Composition.identifier",
"slicing": {
{
"type": "value",
"path": "system"
}
],
"rules": "open"
}
},
{
"id": "Composition.identifier.system",
"path": "Composition.identifier.system",
"min": 1
},
{
"id": "Composition.identifier.value",
"path": "Composition.identifier.value",
"min": 1
},
{
"id": "Composition.identifier.assigner",
"path": "Composition.identifier.assigner",
"type": [
{
"code": "Reference",
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1"
]
}
]
},
{
"id": "Composition.identifier:crossCareSettingIdentifier",
"path": "Composition.identifier",
"sliceName": "crossCareSettingIdentifier",
"min": 1
},
{
"id": "Composition.identifier:crossCareSettingIdentifier.system",
"path": "Composition.identifier.system",
"min": 1,
"fixedUri": "https://fhir.nhs.uk/Id/cross-care-setting-identifier"
},
{
"id": "Composition.identifier:crossCareSettingIdentifier.value",
"path": "Composition.identifier.value",
"min": 1
},
{
"id": "Composition.identifier:crossCareSettingIdentifier.assigner",
"path": "Composition.identifier.assigner",
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-1"
]
}
]
},
{
"id": "Composition.identifier:identifier",
"path": "Composition.identifier",
"sliceName": "identifier"
},
{
"id": "Composition.identifier:identifier.assigner",
"path": "Composition.identifier.assigner",
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-1"
]
}
]
},
{
"id": "Composition.status",
"path": "Composition.status",
"fixedCode": "final"
},
{
"id": "Composition.type",
"path": "Composition.type",
"short": "Kind of composition (SNOMED CT)",
"binding": {
"reference": "https://fhir.hl7.org.uk/STU3/ValueSet/CareConnect-DocumentType-1"
},
"strength": "preferred",
"description": "SNOMED CT Document Type"
}
},
{
"id": "Composition.type.coding",
"path": "Composition.type.coding",
"min": 1
},
{
"id": "Composition.type.coding.system",
"path": "Composition.type.coding.system",
"min": 1,
"fixedUri": "http://snomed.info/sct"
},
{
"id": "Composition.type.coding.version",
"path": "Composition.type.coding.version",
"max": "0"
},
{
"id": "Composition.type.coding.code",
"path": "Composition.type.coding.code",
"min": 1,
"fixedCode": "325851000000107"
},
{
"id": "Composition.type.coding.display",
"path": "Composition.type.coding.display",
"min": 1,
"fixedString": "Consultation"
},
{
"id": "Composition.type.coding.userSelected",
"path": "Composition.type.coding.userSelected",
"max": "0"
},
{
"id": "Composition.subject",
"path": "Composition.subject",
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
]
}
]
},
{
"id": "Composition.encounter",
"path": "Composition.encounter",
"min": 1,
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Encounter-1"
]
}
]
},
{
"id": "Composition.author",
"path": "Composition.author",
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/Device"
]
},
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
},
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1"
]
},
{
"code": "Reference",
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1"
]
}
]
},
{
"id": "Composition.confidentiality",
"path": "Composition.confidentiality",
"max": "0"
},
{
"id": "Composition.attester",
"path": "Composition.attester",
"max": "0"
},
{
"id": "Composition.attester.party",
"path": "Composition.attester.party",
"type": [
{
"code": "Reference",
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1"
]
},
{
"code": "Reference",
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Practitioner-1"
]
},
{
"code": "Reference",
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1"
]
}
]
},
{
"id": "Composition.custodian",
"path": "Composition.custodian",
"max": "0",
"type": [
{
"code": "Reference",
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1"
]
}
]
},
{
"id": "Composition.relatesTo",
"path": "Composition.relatesTo",
"max": "0"
},
{
"id": "Composition.relatesTo.target[x]",
"path": "Composition.relatesTo.target[x]",
"type": [
{
"code": "Identifier"
},
{
"code": "Reference",
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Composition-1"
]
}
]
},
{
"id": "Composition.event",
"path": "Composition.event",
"max": "0"
},
{
"id": "Composition.section",
"path": "Composition.section",
"min": 1
},
{
"id": "Composition.section.extension:problemReference",
"path": "Composition.section.extension",
"sliceName": "problemReference",
"short": "An extension to allow resolution of problem link to composition section.",
"definition": "An extension to allow resolution of the problem link to composition section - will be back reference to problem id … nb this is in the 1st instance intended to be used to resolve the problem reference e.g. problem references composition and consumer must then look for the section with the id that corresponds to the problem to make the linkage",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/STU3/extension-valueset-reference.html"
]
}
]
},
{
"id": "Composition.section.extension:problemReference.url",
"path": "Composition.section.extension.url",
"fixedUri": "http://hl7.org/fhir/STU3/extension-valueset-reference.html"
},
{
"id": "Composition.section.code",
"path": "Composition.section.code",
"min": 1,
"binding": {
"reference": "https://fhir.hl7.org.uk/STU3/ValueSet/CareConnect-CompositionSectionCode-1"
},
"strength": "preferred"
}
},
{
"id": "Composition.section.code.coding",
"path": "Composition.section.code.coding",
"min": 1
},
{
"id": "Composition.section.code.coding.system",
"path": "Composition.section.code.coding.system",
"min": 1,
"fixedUri": "http://snomed.info/sct"
},
{
"id": "Composition.section.code.coding.version",
"path": "Composition.section.code.coding.version",
"max": "0"
},
{
"id": "Composition.section.code.coding.code",
"path": "Composition.section.code.coding.code",
"min": 1,
"fixedCode": "25851000000105"
},
{
"id": "Composition.section.code.coding.display",
"path": "Composition.section.code.coding.display",
"min": 1,
"fixedString": "Topic (EHR)"
},
{
"id": "Composition.section.code.coding.userSelected",
"path": "Composition.section.code.coding.userSelected",
"max": "0"
},
{
"id": "Composition.section.mode",
"path": "Composition.section.mode",
"min": 1,
"fixedCode": "snapshot"
},
{
"id": "Composition.section.orderedBy",
"path": "Composition.section.orderedBy",
"min": 1
},
{
"id": "Composition.section.orderedBy.coding.system",
"path": "Composition.section.orderedBy.coding.system",
"min": 1,
"fixedUri": "http://hl7.org/fhir/ValueSet/list-order"
},
{
"id": "Composition.section.orderedBy.coding.version",
"path": "Composition.section.orderedBy.coding.version",
"max": "0"
},
{
"id": "Composition.section.orderedBy.coding.userSelected",
"path": "Composition.section.orderedBy.coding.userSelected",
"max": "0"
},
{
"id": "Composition.section.entry",
"path": "Composition.section.entry",
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Observation-1"
]
},
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-AllergyIntolerance-1"
]
},
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationRequest-1"
]
},
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/ReferralRequest"
]
}
]
},
{
"id": "Composition.section.emptyReason",
"path": "Composition.section.emptyReason",
"max": "0"
}
]
}
}
Command 'details' could not render: There is no placeholder called 'details'


Reference

Canonical URI: https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Composition-1

The canonical URI is the stable FHIR identifier for this profile and is not currently available as a browsable web page.

Data model element usage

Element Use CareConnect UK Core
id
meta.profile
meta.versionId
meta.lastUpdated
text
extension(careSettingTypeExtension)
identifier
status
type
class
subject
encounter
date
author
title
confidentiality
attester
custodian
relatesTo
event
section

id

Usage

Mandatory

Guidance

The id is the logical identifier for the CareConnect-Composition-1 profile.

Example
<id value="c3ea1a42-5aba-11ed-9b6a-0242ac120002" />


meta.versionId

Usage

Optional

Guidance

This guidance currently relies on MESH as the sending mechanism and, as such, harnesses the MESH .CTL <version> element to indicate the version of the document that is being sent.

However, it is recommended that the meta.versionId element be populated with the version of the document that is being sent. This will be the same version as that populated in the the MESH .CTL file.

Example
<meta>
    <versionId value="1" />
</meta>


meta.lastUpdated

Usage

Optional

Guidance

The meta.lastUpdated element does not need to be populated.

Example
<meta>
    <lastUpdated value="2022-11-02T14:19:00+00:00" />
</meta>


meta.profile

Usage

Mandatory

Guidance

The meta.profile contains a fixed value of the URL for the CareConnect-GPC-Composition-1 profile.

Example
<meta>
    <profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-GPC-Composition-1" />
</meta>


meta.security

Usage

Optional

Guidance

The meta.security element does not need to be populated.

Example
<meta>
    <security>
        <coding>
            <system value="http://hl7.org/fhir/v3/Confidentiality" />
            <code value="L" />
            <display value="low" />
        </coding>
    </security>
</meta>


meta.tag

Usage

Optional

Guidance

The meta.tag element does not need to be populated for this capability.

Example
<meta>
    <tag>
        <coding>
            <system value="http://hl7.org/fhir/common-tags" />
            <code value="actionable" />
            <display value="Actionable" />
        </coding>
    </tag>
</meta>


extension(careSettingTypeExtension)

Usage

Optional

Guidance

A value from a set of SNOMED codes which can be used to describe a type of care setting that the document has come from (if available).

The SNOMED codes have been selected from the 'Services' simple reference set of the SNOMED CT UK coding system.

The most complete list for this valueset can be found in the NHS FHIR HL7 UK Core guidance below:

Simplifier https://simplifier.net/packages/ukcore.r4.02.00.00/2.0.0/files/365046

SNOMED CT Browser https://termbrowser.nhs.uk/?perspective=full&conceptId1=1127531000000102

Example
<extension url="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-CareSettingType-1">
    <valueCodeableConcept>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="983341000000102" />
            <display value="Pharmacy First service (qualifier value)" />
        </coding>
    </valueCodeableConcept>
</extension>


identifier

Usage

Optional

Guidance

It is highly recommended that the logical id value is a Universally Unique Identifier (UUID) using a standard UUID generator available in most programming languages.


status

Usage

Mandatory

Guidance
Note:It is expected that this capability will not be used to send documents that are currently being worked on and, while it could potentially be used to do so, care must be taken by both the sender and receiver in how to handle documents with different statuses.

At the time of writing, the codesystem for CompositionStatus contains the following:

  • preliminary
  • final
  • amended
  • entered-in-error

View the up-to-date STU3 codesystem here

The diagram below represents how the composition can transition through the available statuses.


type

Usage

Mandatory

Guidance

The type of composition being supplied - a value from the Record composition type simple reference set (foundation metadata concept) is preferred.

Example
<coding>
    <system value="http://snomed.info/sct" />
    <code value="1082101000000102" />
    <display value="Investigation results (record artifact)" />
</coding>


class

Usage

Optional

Guidance

A use case for this element has not been defined at the time of writing this guidance.


subject

Usage

Mandatory

Guidance

The subject MUST contain a Patient resource profiled to the CareConnect-GPC-Patient-1 structure definition

More information about how to populate this resource can be found in this guide using the link below.

Command 'pagelink' could not render: Page not found.


encounter

Usage

Mandatory

Guidance
This element **MUST** be used to reference the encounter that this activity relates to.
Example
```xml ```

date

Usage

Mandatory

Guidance

The date element MUST contain the date and time that the message was created.


author

Usage

Mandatory

Guidance

The author MUST contain an Practitioner resource profiled to the CareConnect-GPC-Practitioner-1 structure definition

More information about how to populate this resource can be found in this guide using the link below.

Command 'pagelink' could not render: Page not found.


title

Usage

Mandatory

Guidance

The title MUST contain a value in relation to the type of activity you are sending.

Example
<title value="[Insert Document Title Here]" />


attester

Usage

Optional

Guidance

At the time of writing this article, the attester element has not been defined; however, the Composition.attester.mode element may be pertinent for certain types of payloads, in relation to the information they contain.

A future version of this guidance may request that this element be used.


text

Usage

Optional

Guidance

A human-readable description of the payload being sent - using HTML.

Example
<text>
    <status value="generated" />
    <div xmlns="http://www.w3.org/1999/xhtml"><p>[payload-title] for [patient-name], NHS Number: [nhs-number], seen at [practice-name], [ods-code], Version: [version-number]</p></div>
</text>


confidentiality

Usage

Optional

Guidance

The confidentiality MUST contain one of the following values if used:

  • N (Normal)
  • R (Restricted) - if the document is classed as confidential

Additional codes are defined by the base HL7 FHIR standard; however, guidance around how they should be interpreted cannot be defined at this time.

HL7 Value Set ConfidentialityClassification (v3)

Note: If a payload is restricted, then the contents of the document may be redacted; however, the pointers to the document source will exist, should an actor require additional information about the payload.
Example
<!-- Normal -->
<confidentiality value="N" />

<!-- Restricted -->
<confidentiality value="R" />


relatesTo

Usage

Optional

Guidance

Used to determine whether the composition relates to another - for example, whether it "replaces" another.

Example
<relatesTo>
    <code value="replaces" />
    <targetIdentifier value="e255cf10-db3c-11ec-9d64-0242ac120002" />
</relatesTo>


event

Usage

Optional

Guidance

Additional context about the event being sent within the composition.

Example
<event>
    <coding>
        <system value="http://snomed.info/sct" />
        <code value="755491000000100" />
        <display value="Diabetes structured education programme completed (situation) " />
    </coding>
</event>


section

Usage

Mandatory

Guidance

Entries relating to the composition being provided. At least one should be supplied.

Example
<section>
    <!-- CareConnect-GPC-Encounter-1 -->
    <entry>
        <reference value="urn:be36bcc0-1279-43ca-ae4e-2b1c5fc2e4fd" />
    </entry>
</section>

back to top