• 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
• 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()
• bdystr-1: bodyStructure SHALL only be present if bodySite is not present
  bodySite.exists() implies bodyStructure.empty()
• prr-1: orderDetail SHALL only be present if code is present
  orderDetail.empty() or code.exists()

• rim: n/a
• rim: Entity. Role, or Act
• rim: Entity, Role, or Act
• workflow: Request
• w5: clinical.general
• v2: ORC
• rim: Act[moodCode<=INT]

Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

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

• rim: n/a
• rim: N/A

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

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

• rim: n/a

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

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

• rim: n/a

Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

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

• rim: n/a
• rim: N/A
• rim: Act.text?

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

• rim: n/a
• rim: Entity. Role, or Act
• rim: N/A

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

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

• rim: n/a
• rim: N/A

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

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

• rim: n/a
• rim: N/A

The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 V2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 V2). For further discussion and examples see the resource notes section below.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ident-1: Identifier with no value has limited utility. If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason
  value.exists()

• rim: n/a
• v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
• rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
• servd: Identifier
• workflow: Request.identifier
• w5: FiveWs.identifier
• v2: ORC-2, ORC-3, RF1-6 / RF1-11,
• rim: .identifier
• quick: ClinicalStatement.identifier

The PlanDefinition resource is used to describe series, sequences, or groups of actions to be taken, while the ActivityDefinition resource is used to define each specific step or activity to be performed. More information can be found in the Boundaries and Relationships section for PlanDefinition.

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

• rim: n/a
• workflow: Request.instantiatesCanonical
• v2: Varies by domain
• rim: .outboundRelationship[typeCode=DEFN].target

This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

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

• rim: n/a
• workflow: Request.instantiatesUri
• v2: Varies by domain
• rim: .outboundRelationship[typeCode=DEFN].target

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

• 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))
• ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
  reference.exists() or identifier.exists() or display.exists() or extension.exists()

• rim: n/a
• rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
• workflow: Request.basedOn
• v2: ORC-8 (plus others)
• rim: .outboundRelationship[typeCode=FLFS].target

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

• 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))
• ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
  reference.exists() or identifier.exists() or display.exists() or extension.exists()

• rim: n/a
• rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
• workflow: Request.replaces
• v2: Handled by message location of ORC (ORC-1=RO or RU)
• rim: .outboundRelationship[typeCode=RPLC].target

Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes.

Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ident-1: Identifier with no value has limited utility. If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason
  value.exists()

• rim: n/a
• v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
• rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
• servd: Identifier
• workflow: Request.groupIdentifier
• v2: ORC-4
• rim: .inboundRelationship(typeCode=COMP].source[moodCode=INT].identifier

The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, revoked or placed on-hold. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.

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

• rim: n/a
• workflow: Request.status
• w5: FiveWs.status
• v2: ORC-5,RF1-1
• rim: .status
• quick: Action.currentStatus

This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

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

• rim: n/a
• workflow: Request.intent
• w5: FiveWs.class
• v2: N/A
• rim: .moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)

Used for filtering what service request are retrieved and displayed.

There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

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

• rim: n/a
• v2: CE/CNE/CWE
• rim: CD
• orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
• w5: FiveWs.class
• v2: RF1-5
• rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="INT"].code

Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size

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

routine

• rim: n/a
• workflow: Request.priority
• w5: FiveWs.grade
• v2: TQ1.9, RF1-2
• rim: .priorityCode

Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.

In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.

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

• rim: n/a
• workflow: Request.doNotPerform
• rim: .actionNegationInd

Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code.

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

• rim: n/a
• workflow: Request.code
• w5: FiveWs.what[x]
• v2: PR1-3 / OBR-4 (varies by domain)
• rim: .code
• quick: Procedure.procedureCode

For information from the medical record intended to support the delivery of the requested services, use the supportingInformation element.

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

• rim: n/a
• v2: NTE

• rim: n/a

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

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

• rim: n/a
• rim: N/A

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

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

• rim: n/a
• rim: N/A

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

• rim: n/a

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

• rim: n/a

• rim: n/a

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

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

• rim: n/a
• rim: N/A

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

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

• rim: n/a
• rim: N/A

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

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

• rim: n/a
• v2: CE/CNE/CWE
• rim: CD
• orim: fhir:CodeableConcept rdfs:subClassOf dt:CD

CodeableConcept values are indented to express concepts that would normally be coded - when a code is not available for a concept, CodeableConcept.text can be used. When the data is a text or not a single identifiable concept, string should be used.

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

• rim: n/a

When ordering a service the number of service items may need to be specified separately from the the service item.

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

• rim: n/a
• v2: NTE
• rim: .quantity

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

• 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))
• ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
  reference.exists() or identifier.exists() or display.exists() or extension.exists()

• rim: n/a
• rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
• workflow: Request.subject
• w5: FiveWs.subject[x]
• v2: PID
• rim: .participation[typeCode=SBJ].role
• quick: ClinicalStatement.subject

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

• 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))
• ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
  reference.exists() or identifier.exists() or display.exists() or extension.exists()

• 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]

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

• 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))
• ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
  reference.exists() or identifier.exists() or display.exists() or extension.exists()

• rim: n/a
• rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
• workflow: Request.encounter
• w5: FiveWs.context
• v2: PV1
• rim: .inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN]
• quick: ClinicalStatement.encounter

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

• rim: n/a
• workflow: Request.occurrence[x]
• w5: FiveWs.planned
• v2: TQ1/TQ2, OBR-7/OBR-8
• rim: .effectiveTime
• quick: Procedure.procedureSchedule

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

• rim: n/a
• rim: boolean: precondition.negationInd (inversed - so negationInd = true means asNeeded=false CodeableConcept: precondition.observationEventCriterion[code="Assertion"].value
• quick: Proposal.prnReason.reason

UTC offset is allowed for dates and partial dates

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

• rim: n/a
• workflow: Request.authoredOn
• w5: FiveWs.recorded
• v2: ORC-9, RF1-7 / RF1-9
• rim: .participation[typeCode=AUT].time
• quick: Proposal.proposedAtTime

This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource.

• 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))
• ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
  reference.exists() or identifier.exists() or display.exists() or extension.exists()

• rim: n/a
• rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
• workflow: Request.requester
• w5: FiveWs.author
• v2: ORC-12, PRT
• rim: .participation[typeCode=AUT].role
• quick: ClinicalStatement.statementAuthor

This is a role, not a participation type. In other words, does not describe the task but describes the capacity. For example, “compounding pharmacy”, “psychiatrist” or “internal referral”.

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

• rim: n/a
• v2: CE/CNE/CWE
• rim: CD
• orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
• workflow: Request.performerType
• w5: FiveWs.actor
• v2: PRT, RF1-3
• rim: .participation[typeCode=PRF].role[scoper.determinerCode=KIND].code

If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the http://hl7.org/fhir/StructureDefinition/request-performerOrder. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B).

• 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))
• ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
  reference.exists() or identifier.exists() or display.exists() or extension.exists()

• rim: n/a
• rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
• workflow: Request.performer
• w5: FiveWs.actor
• v2: PRT, Practitioner: PRD-2/PRD-7 where PRD-3 = RT; Organization: PRD-10 where PRD-3 = RT
• rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]

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

• rim: n/a
• w5: FiveWs.actor
• rim: .participation[typeCode=LOC].role[scoper.determinerCode=KIND].code

This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise, use concept.text element if the data is free (uncoded) text as shown in the CT Scan example.

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

• rim: n/a
• workflow: Request.reason
• w5: FiveWs.why[x]
• v2: ORC-16, RF1-10
• rim: .reasonCode

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

• 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))
• ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
  reference.exists() or identifier.exists() or display.exists() or extension.exists()

• rim: n/a
• rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
• workflow: Request.insurance
• v2: IN1/IN2
• rim: .outboundRelationship[typeCode=COVBY].target

To represent information about how the services are to be delivered use the instructions element.

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

• rim: n/a
• workflow: Request.supportingInfo
• v2: Accompanying segments
• rim: .outboundRelationship[typeCode=PERT].target

The purpose of the ServiceRequest.specimen is to reflect the actual specimen that the requested test/procedure is asked to be performed on, whether the lab already has it or not. References to specimens for purposes other than to perform a test/procedure on should be made using the ServiceRequest.supportingInfo or the Specimen.parent where the Specimen.parent would enable descendency and ServiceRequest.supportingInfo a general reference for context.

• 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))
• ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
  reference.exists() or identifier.exists() or display.exists() or extension.exists()

• rim: n/a
• rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
• v2: SPM
• rim: .participation[typeCode=SPC].role

Knowing where the procedure is performed is important for tracking if multiple sites are possible.

Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension http://hl7.org/fhir/StructureDefinition/procedure-targetBodyStructure.

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

• rim: n/a
• v2: CE/CNE/CWE
• rim: CD
• orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
• v2: SPM
• rim: targetSiteCode
• quick: Procedure.targetBodySite

Knowing where the procedure is performed is important for tracking if multiple sites are possible.

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

• 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))
• ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
  reference.exists() or identifier.exists() or display.exists() or extension.exists()

• rim: n/a
• rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
• v2: SPM
• rim: targetSiteCode
• quick: Procedure.targetBodyStructure

For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

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

• rim: n/a
• v2: N/A
• rim: Act
• workflow: Request.note
• v2: NTE
• rim: .inboundRelationship(typeCode=SUBJ].source[classCode=ANNGEN, moodCode=EVN].value[xsi:type=ST]
• quick: ClinicalStatement.additionalText

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

• rim: n/a
• v2: NTE
• rim: .text

• rim: n/a

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

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

• rim: n/a
• rim: N/A

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

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

• rim: n/a
• rim: N/A

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

• rim: n/a
• v2: NTE
• rim: .text

This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.

• 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))
• ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
  reference.exists() or identifier.exists() or display.exists() or extension.exists()

• rim: n/a
• rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
• workflow: Request.relevantHistory
• v2: N/A
• rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]