LuxithDocumentReferenceProfile

⚠️ This is an introduction of our profile LuxithDocumentReferenceProfile

Metadata

These are the details for this resource:

Resource content

These are different views on this resource:

This is the tree view:
idΣ0..1id
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
textI0..1Narrative
containedI0..*Resource
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
identifierΣ I0..*Identifier
versionΣ0..0string
basedOnI0..0Reference(Appointment | AppointmentResponse | CarePlan | Claim | CommunicationRequest | Contract | CoverageEligibilityRequest | DeviceRequest | EnrollmentRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | SupplyRequest | VisionPrescription)
statusΣ ?!1..1codeBinding
docStatusΣ1..1codeBinding
modalityΣ0..0CodeableConceptBinding
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
systemΣ0..0uri
versionΣ0..0string
codeΣ I0..1code
displayΣ I0..0string
userSelectedΣ0..0boolean
textΣ1..1string
subjectΣ I0..1Reference(Resource)
contextI0..*Reference(Appointment | Encounter | EpisodeOfCare)
event0..1CodeableReference()
bodySiteΣ0..0CodeableReference(BodyStructure)
id0..1string
extensionI0..*Extension
codingΣ I0..0Coding
textΣ1..1string
practiceSettingI0..0CodeableConcept
periodΣ I0..0Period
dateΣ0..1instant
authorΣ I0..1Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson | CareTeam)
custodianI0..1Reference(Organization)
descriptionΣ0..1markdown
securityLabelΣ0..1CodeableConcept
id0..1string
extensionI0..1Extension
modifierExtensionΣ ?! I0..0Extension
id0..1string
extensionI0..*Extension
contentTypeΣ I1..1codeBinding
languageΣ0..0codeBinding
dataI1..1base64Binary
urlΣ0..1url
sizeΣ1..1integer64
hashΣ0..1base64Binary
titleΣ0..1string
creationΣ0..1dateTime
height0..0positiveInt
width0..0positiveInt
frames0..0positiveInt
duration0..0decimal
pages0..1positiveInt
This is the detailed view:
DocumentReference
DefinitionA reference to a document of any kind for any purpose. While the term “document” implies a more narrow focus, for this resource this "document" encompasses *any* serialized object with a mime-type, it includes formal patient-centric documents (CDA), clinical notes, scanned paper, non-patient specific documents like policy text, as well as a photo, video, or audio recording acquired or used in healthcare. The DocumentReference resource provides metadata about the document so that the document can be discovered and managed. The actual content may be inline base64 encoded data or provided by direct reference.
Cardinality0...*
Comments

Usually, this is used for documents other than those defined by FHIR.

Invariants
  • 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()
  • docRef-1: facilityType SHALL only be present if context is not an encounter
    facilityType.empty() or context.where(resolve() is Encounter).empty()
  • docRef-2: practiceSetting SHALL only be present if context is not present
    practiceSetting.empty() or context.where(resolve() is Encounter).empty()
Mappings
  • rim: n/a
  • rim: Entity. Role, or Act
  • rim: Entity, Role, or Act
  • workflow: Event
  • w5: infrastructure.documents
  • fhircomposition: when describing a Composition
  • rim: Document[classCode="DOC" and moodCode="EVN"]
  • xds: DocumentEntry
  • cda: when describing a CDA
DocumentReference.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typeid
SummaryTrue
Comments

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.

DocumentReference.meta
DefinitionThe 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
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
DocumentReference.implicitRules
DefinitionA 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 its narrative along with other profiles, value sets, etc.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
DocumentReference.language
DefinitionThe base language in which the resource is written.
Cardinality0...1
Typecode
Binding

IETF language tag for a human language

AllLanguages (required)
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).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
DocumentReference.text
DefinitionA 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 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.

Invariants
  • 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?
DocumentReference.contained
DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.
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: n/a
  • rim: Entity. Role, or Act
  • rim: N/A
DocumentReference.extension
DefinitionMay 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 managable, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DocumentReference.modifierExtension
DefinitionMay 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 managable, 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
SummaryTrue
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DocumentReference.identifier
DefinitionOther business identifiers associated with the document, including version independent identifiers.
Cardinality0...*
TypeIdentifier
SummaryTrue
Requirements

Document identifiers usually assigned by the source of the document, or other business identifiers such as XDS DocumentEntry.uniqueId and DocumentEntry.entryUUID. These identifiers are specific to this instance of the document.

Comments

The structure and format of this identifier would be consistent with the specification corresponding to the format of the document. (e.g. for a DICOM standard document, a 64-character numeric UID; for an HL7 CDA format, the CDA Document Id root and extension).

SlicingUnordered, Open, by $this(Pattern)
Invariants
  • 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()
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
  • fhircomposition: Composition.identifier
  • v2: TXA-12
  • rim: .id / .setId
  • xds: DocumentEntry.entryUUID, DocumentEntry.uniqueId
  • cda: ClinicalDocument/id
DocumentReference.version
DefinitionAn explicitly assigned identifer of a variation of the content in the DocumentReference.
Cardinality0...0
Typestring
SummaryTrue
Comments

While each resource, including the DocumentReference itself, has its own version identifier, this is a formal identifier for the logical version of the DocumentReference as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • w5: FiveWs.version
  • fhircomposition: Composition.version
DocumentReference.basedOn
DefinitionA procedure that is fulfilled in whole or in part by the creation of this media.
Cardinality0...0
TypeReference(Appointment | AppointmentResponse | CarePlan | Claim | CommunicationRequest | Contract | CoverageEligibilityRequest | DeviceRequest | EnrollmentRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | SupplyRequest | VisionPrescription)
Aliasfulfills
Requirements

Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

Comments

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.

Invariants
  • 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()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim: .outboundRelationship[typeCode=FLFS].target
  • xds: DocumentEntry.referenceIdList
DocumentReference.status
DefinitionThe status of this document reference.
Cardinality1...1
Typecode
Binding

The status of the document reference.

DocumentReferenceStatus (required)
ModifierTrue
SummaryTrue
Comments

This is the status of the DocumentReference object, which might be independent from the docStatus element.

This element is labeled as a modifier because the status contains the codes that mark the document or reference as not currently valid.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.status
  • w5: FiveWs.status
  • v2: TXA-19
  • 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("ReviseDocument", code) and isNormalAct()]); amended: .completionCode="AU" && ./statusCode[isNormalDatatype()]="complete" and ./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[subsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("ReviseDocument", code) and isNormalAct() and statusCode="completed"]; withdrawn : .completionCode=NI && ./statusCode[isNormalDatatype()]="obsolete"
  • xds: DocumentEntry.availabilityStatus
DocumentReference.docStatus
DefinitionThe status of the underlying document.
Cardinality1...1
Typecode
Binding

Status of the underlying document.

CompositionStatus (required)
SummaryTrue
Comments

The document that is pointed to might be in various lifecycle states.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • w5: FiveWs.status
  • fhircomposition: Composition.status
  • v2: TXA-17
  • rim: .statusCode
DocumentReference.modality
DefinitionImaging modality used. This may include both acquisition and non-acquisition modalities.
Cardinality0...0
TypeCodeableConcept
Binding

Type of acquired data in the instance.

http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_33.html (extensible)
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.class
DocumentReference.type
DefinitionSpecifies the particular kind of document referenced (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the document referenced.
Cardinality1...1
TypeCodeableConcept
Binding

Precise type of clinical document.

FHIRDocumentTypeCodes (preferred)
SummaryTrue
Comments

Key metadata element describing the document that describes he exact type of document. Helps humans to assess whether the document is of interest when viewing a list of documents.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Event.code
  • w5: FiveWs.what[x]
  • fhircomposition: Composition.type
  • v2: TXA-2
  • rim: ./code
  • xds: DocumentEntry.typeCode
  • cda: ClinicalDocument/code/@code The typeCode should be mapped from the ClinicalDocument/code element to a set of document type codes configured in the affinity domain. One suggested coding system to use for typeCode is LOINC, in which case the mapping step can be omitted.
DocumentReference.type.id
DefinitionUnique 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
DocumentReference.type.extension
DefinitionMay 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 managable, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DocumentReference.type.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality1...1
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • cod-1: A Coding SHOULD NOT have a display unless a code is also present. Computation on Coding.display alone is generally unsafe. Consider using CodeableConcept.text
    code.exists().not() implies display.exists().not()
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
DocumentReference.type.coding.id
DefinitionUnique 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
DocumentReference.type.coding.extension
DefinitionMay 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 managable, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DocumentReference.type.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...0
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 be an absolute reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
DocumentReference.type.coding.version
DefinitionThe 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.

Invariants
  • 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
DocumentReference.type.coding.code
DefinitionA 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 1,048,576 (1024*1024) characters in size

Invariants
  • 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
DocumentReference.type.coding.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...0
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 1,048,576 (1024*1024) characters in size

Invariants
  • 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
DocumentReference.type.coding.userSelected
DefinitionIndicates 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.

Invariants
  • 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 ]
DocumentReference.type.text
DefinitionA 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.
Cardinality1...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.

Invariants
  • 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
DocumentReference.category
DefinitionA categorization for the type of document referenced - helps for indexing and searching. This may be implied by or derived from the code specified in the DocumentReference.type.
Cardinality0...0
TypeCodeableConcept
Binding

High-level kind of document at a macro level.

ReferencedItemCategoryValueSet (example)
SummaryTrue
Aliasclass, classCode
Comments

Key metadata element describing the the category or classification of the document. This is a broader perspective that groups similar documents based on how they would be used. This is a primary key used in searching.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.what[x]
  • fhircomposition: Composition.category
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
  • xds: DocumentEntry.classCode
  • cda: Derived from a mapping of /ClinicalDocument/code/@code to an Affinity Domain specified coded value to use and coding system. Affinity Domains are encouraged to use the appropriate value for Type of Service, based on the LOINC Type of Service (see Page 53 of the LOINC User's Manual). Must be consistent with /ClinicalDocument/code/@code
DocumentReference.category.id
DefinitionUnique 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
DocumentReference.category.extension
DefinitionMay 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 managable, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DocumentReference.category.coding
DefinitionA 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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • cod-1: A Coding SHOULD NOT have a display unless a code is also present. Computation on Coding.display alone is generally unsafe. Consider using CodeableConcept.text
    code.exists().not() implies display.exists().not()
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
DocumentReference.category.coding.id
DefinitionUnique 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
DocumentReference.category.coding.extension
DefinitionMay 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 managable, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DocumentReference.category.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...0
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 be an absolute reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
DocumentReference.category.coding.version
DefinitionThe 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.

Invariants
  • 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
DocumentReference.category.coding.code
DefinitionA 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 1,048,576 (1024*1024) characters in size

Invariants
  • 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
DocumentReference.category.coding.display
DefinitionA 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 1,048,576 (1024*1024) characters in size

Invariants
  • 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
DocumentReference.category.coding.userSelected
DefinitionIndicates 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.

Invariants
  • 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 ]
DocumentReference.category.text
DefinitionA 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.
Cardinality1...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.

Invariants
  • 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
DocumentReference.subject
DefinitionWho or what the document is about. The document 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 farm animals, or a set of patients that share a common exposure).
Cardinality0...1
TypeReference(Resource)
SummaryTrue
Comments

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.

Invariants
  • 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()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.subject
  • w5: FiveWs.subject[x]
  • fhircomposition: Composition.subject
  • v2: PID-3 (No standard way to define a Practitioner or Group subject in HL7 V2 MDM message)
  • rim: .participation[typeCode="SBJ"].role[typeCode="PAT"]
  • xds: DocumentEntry.patientId
  • cda: ClinicalDocument/recordTarget/
DocumentReference.context
DefinitionDescribes the clinical encounter or type of care that the document content is associated with.
Cardinality0...*
TypeReference(Appointment | Encounter | EpisodeOfCare)
Comments

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.

Invariants
  • 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()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.encounter
  • w5: FiveWs.context
  • fhircomposition: Composition.encounter
  • rim: unique(highest(./outboundRelationship[typeCode="SUBJ" and isNormalActRelationship()], priorityNumber)/target[moodCode="EVN" and classCode=("ENC", "PCPR") and isNormalAct])
DocumentReference.event
DefinitionThis 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 type Code, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.
Cardinality0...1
TypeCodeableReference()
Binding

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

http://terminology.hl7.org/ValueSet/v3-ActCode (example)
Comments

An event can further specialize the act inherent in the type, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more event codes are included, they shall not conflict with the values inherent in the class or type elements as such a conflict would create an ambiguous situation.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • fhircomposition: Composition.event.detail
  • rim: .code
  • xds: DocumentEntry.referenceIdList
DocumentReference.bodySite
DefinitionThe anatomic structures included in the document.
Cardinality0...0
TypeCodeableReference(BodyStructure)
Binding

SNOMED CT Body site concepts

SNOMEDCTBodyStructures (example)
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .targetSiteCode
DocumentReference.facilityType
DefinitionThe kind of facility where the patient was seen.
Cardinality0...1
TypeCodeableConcept
Binding

XDS Facility Type.

FacilityTypeCodeValueSet (example)
Comments

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

Invariants
  • 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
  • fhircomposition: usually from a mapping to a local ValueSet
  • rim: .participation[typeCode="LOC"].role[classCode="DSDLOC"].code
  • xds: DocumentEntry.healthcareFacilityTypeCode
  • cda: usually a mapping to a local ValueSet. Must be consistent with /clinicalDocument/code
DocumentReference.facilityType.id
DefinitionUnique 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
DocumentReference.facilityType.extension
DefinitionMay 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 managable, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DocumentReference.facilityType.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...0
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • cod-1: A Coding SHOULD NOT have a display unless a code is also present. Computation on Coding.display alone is generally unsafe. Consider using CodeableConcept.text
    code.exists().not() implies display.exists().not()
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
DocumentReference.facilityType.text
DefinitionA 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.
Cardinality1...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.

Invariants
  • 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
DocumentReference.practiceSetting
DefinitionThis property may convey specifics about the practice setting where the content was created, often reflecting the clinical specialty.
Cardinality0...0
TypeCodeableConcept
Binding

Additional details about where the content was created (e.g. clinical specialty).

PracticeSettingCodeValueSet (example)
Requirements

This is an important piece of metadata that providers often rely upon to quickly sort and/or filter out to find specific content.

Comments

This element should be based on a coarse classification system for the class of specialty practice. Recommend the use of the classification system for Practice Setting, such as that described by the Subject Matter Domain in LOINC.

Invariants
  • 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
  • fhircomposition: usually from a mapping to a local ValueSet
  • rim: .participation[typeCode="LOC"].role[classCode="DSDLOC"].code
  • xds: DocumentEntry.practiceSettingCode
  • cda: usually from a mapping to a local ValueSet
DocumentReference.period
DefinitionThe time period over which the service that is described by the document was provided.
Cardinality0...0
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.

Invariants
  • 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 or equal value than end
    start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() <= end.highBoundary())
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • fhircomposition: Composition.event.period
  • rim: .effectiveTime
  • xds: DocumentEntry.serviceStartTime, DocumentEntry.serviceStopTime
  • cda: ClinicalDocument/documentationOf/ serviceEvent/effectiveTime/low/ @value --> ClinicalDocument/documentationOf/ serviceEvent/effectiveTime/high/ @value
DocumentReference.date
DefinitionWhen the document reference was created.
Cardinality0...1
Typeinstant
SummaryTrue
Aliasindexed
Comments

Referencing/indexing time is used for tracking, organizing versions and searching.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.occurrence[x]
  • w5: FiveWs.recorded
  • fhircomposition: Composition.date
  • rim: .availabilityTime[type="TS"]
DocumentReference.author
DefinitionIdentifies who is responsible for adding the information to the document.
Cardinality0...1
TypeReference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson | CareTeam)
SummaryTrue
Comments

Not necessarily who did the actual data entry (i.e. typist) or who was the source (informant).

Invariants
  • 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()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.performer.actor
  • fhircomposition: Composition.author
  • v2: TXA-9 (No standard way to indicate a Device in HL7 V2 MDM message)
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • xds: DocumentEntry.author
  • cda: ClinicalDocument/author
DocumentReference.attester
DefinitionA participant who has authenticated the accuracy of the document.
Cardinality0...0
TypeBackboneElement
Requirements

Identifies responsibility for the accuracy of the document content.

Comments

Only list each attester once.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.performer.actor
  • fhircomposition: Composition.attester
  • rim: .participation[typeCode="AUTHEN"].role[classCode="ASSIGNED"]
  • xds: DocumentEntry.legalAuthenticator
  • cda: .authenticator/.legalAuthenticator
DocumentReference.attester.id
DefinitionUnique 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
DocumentReference.attester.extension
DefinitionMay 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 managable, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DocumentReference.attester.modifierExtension
DefinitionMay 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 managable, 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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DocumentReference.attester.mode
DefinitionThe type of attestation the authenticator offers.
Cardinality1...1
TypeCodeableConcept
Binding

The way in which a person authenticated a document.

CompositionAttestationMode (preferred)
Requirements

Indicates the level of authority of the attestation.

Comments

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

Invariants
  • 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
  • fhircomposition: Composition.attester.mode
  • rim: unique(./modeCode)
  • cda: implied by .authenticator/.legalAuthenticator
DocumentReference.attester.time
DefinitionWhen the document was attested by the party.
Cardinality0...1
TypedateTime
Requirements

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

Comments

UTC offset is allowed for dates and partial dates

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • fhircomposition: Composition.attester.time
  • rim: ./time[type="TS" and isNormalDatatype()]
  • cda: .authenticator.time
DocumentReference.attester.party
DefinitionWho attested the document in the specified way.
Cardinality0...1
TypeReference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization)
Requirements

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

Comments

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.

Invariants
  • 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()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.witness
  • fhircomposition: Composition.attester.party
  • v2: TXA-10
  • 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
DocumentReference.custodian
DefinitionIdentifies the organization or group who is responsible for ongoing maintenance of and access to the document.
Cardinality0...1
TypeReference(Organization)
Comments

Identifies the logical organization (software system, vendor, or department) to go to find the current version, where to report issues, etc. This is different from the physical location (URL, disk drive, or server) of the document, which is the technical location of the document, which host may be delegated to the management of some other organization.

Invariants
  • 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()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.performer.actor
  • fhircomposition: Composition.custodian
  • rim: .participation[typeCode="RCV"].role[classCode="CUST"].scoper[classCode="ORG" and determinerCode="INST"]
DocumentReference.relatesTo
DefinitionRelationships that this document has with other document references that already exist.
Cardinality0...0
TypeBackboneElement
SummaryTrue
Comments

This element is labeled as a modifier because documents that append to other documents are incomplete on their own.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • fhircomposition: Composition.relatesTo
  • rim: .outboundRelationship
  • xds: DocumentEntry Associations
DocumentReference.relatesTo.id
DefinitionUnique 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
DocumentReference.relatesTo.extension
DefinitionMay 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 managable, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DocumentReference.relatesTo.modifierExtension
DefinitionMay 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 managable, 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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DocumentReference.relatesTo.code
DefinitionThe type of relationship that this document has with anther document.
Cardinality1...1
TypeCodeableConcept
Binding

The type of relationship between the documents.

DocumentRelationshipType (extensible)
SummaryTrue
Comments

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

Invariants
  • 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
  • fhircomposition: Composition.relatesTo.type
  • rim: .outboundRelationship.typeCode
  • xds: DocumentEntry Associations type
  • cda: ClinicalDocument/relatedDocument/typeCode
DocumentReference.relatesTo.target
DefinitionThe target document of this relationship.
Cardinality1...1
TypeReference(DocumentReference)
SummaryTrue
Comments

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.

Invariants
  • 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()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • fhircomposition: Composition.relatesTo.resourceReference
  • rim: .target[classCode="DOC", moodCode="EVN"].id
  • xds: DocumentEntry Associations reference
  • cda: ClinicalDocument/relatedDocument/parentDocument
DocumentReference.description
DefinitionHuman-readable description of the source document.
Cardinality0...1
Typemarkdown
SummaryTrue
Requirements

Helps humans to assess whether the document is of interest.

Comments

What the document is about, a terse summary of the document.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: TXA-25
  • rim: .outboundRelationship[typeCode="SUBJ"].target.text
  • xds: DocumentEntry.comments
DocumentReference.securityLabel
DefinitionA set of Security-Tag codes specifying the level of privacy/security of the Document found at DocumentReference.content.attachment.url. Note that DocumentReference.meta.security contains the security labels of the data elements in DocumentReference, while DocumentReference.securityLabel contains the security labels for the document the reference refers to. The distinction recognizes that the document may contain sensitive information, while the DocumentReference is metadata about the document and thus might not be as sensitive as the document. For example: a psychotherapy episode may contain highly sensitive information, while the metadata may simply indicate that some episode happened.
Cardinality0...1
TypeCodeableConcept
Binding

Example Security Labels from the Healthcare Privacy and Security Classification System.

SecurityLabelExamples (example)
SummaryTrue
Requirements

Use of the Health Care Privacy/Security Classification (HCS) system of security-tag use is recommended.

Comments

The confidentiality codes can carry multiple vocabulary items. HL7 has developed an understanding of security and privacy tags that might be desirable in a Document Sharing environment, called HL7 Healthcare Privacy and Security Classification System (HCS). The following specification is recommended but not mandated, as the vocabulary bindings are an administrative domain responsibility. The use of this method is up to the policy domain such as the XDS Affinity Domain or other Trust Domain where all parties including sender and recipients are trusted to appropriately tag and enforce.

In the HL7 Healthcare Privacy and Security Classification (HCS) there are code systems specific to Confidentiality, Sensitivity, Integrity, and Handling Caveats. Some values would come from a local vocabulary as they are related to workflow roles and special projects.

Invariants
  • 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
  • fhircomposition: Bundle.meta.security
  • v2: TXA-18
  • rim: .confidentialityCode
  • xds: DocumentEntry.confidentialityCode
  • cda: ClinicalDocument/confidentialityCode/@code
DocumentReference.content
DefinitionThe document and format referenced. If there are multiple content element repetitions, these must all represent the same document in different format, or attachment metadata.
Cardinality1...*
TypeBackboneElement
SummaryTrue
Requirements

Note that .relatesTo may also include references to other DocumentReference with a transforms relationship to represent the same document in multiple formats.

Comments

content element shall not contain different versions of the same content. For version handling use multiple DocumentReference with .relatesTo.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • fhircomposition: Bundle(Composition+*)
  • rim: document.text
DocumentReference.content.id
DefinitionUnique 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
DocumentReference.content.extension
DefinitionMay 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 managable, 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
Requirements

This extension holds an AES key that has been encrypted with an RSA public key

Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DocumentReference.content.modifierExtension
DefinitionMay 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 managable, 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...0
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DocumentReference.content.attachment
DefinitionThe document or URL of the document along with critical metadata to prove content has integrity.
Cardinality1...1
TypeAttachment
SummaryTrue
Comments

When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Signed Procedure Consent".

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • att-1: If the Attachment has data, it SHALL have a contentType
    data.empty() or contentType.exists()
Mappings
  • rim: n/a
  • v2: ED/RP
  • rim: ED
  • fhircomposition: Composition.language, Composition.title, Composition.date
  • v2: TXA-3 for mime type
  • rim: document.text
  • xds: DocumentEntry.mimeType, DocumentEntry.languageCode, DocumentEntry.URI, DocumentEntry.size, DocumentEntry.hash, DocumentEntry.title, DocumentEntry.creationTime
  • cda: ClinicalDocument/languageCode, ClinicalDocument/title, ClinicalDocument/date
DocumentReference.content.attachment.id
DefinitionUnique 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
DocumentReference.content.attachment.extension
DefinitionMay 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 managable, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DocumentReference.content.attachment.contentType
DefinitionIdentifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.
Cardinality1...1
Typecode
Binding

BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049)

MimeTypes (required)
SummaryTrue
Requirements

Processors of the data need to be able to know how to interpret the data.

Comments

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

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

text/plain; charset=UTF-8, image/png


Mappings
  • rim: n/a
  • v2: ED.2+ED.3/RP.2+RP.3. Note conversion may be needed if old style values are being used
  • rim: ./mediaType, ./charset
DocumentReference.content.attachment.language
DefinitionThe human language of the content. The value can be any valid value according to BCP 47.
Cardinality0...0
Typecode
Binding

IETF language tag for a human language.

AllLanguages (required)
SummaryTrue
Requirements

Users need to be able to choose between the languages in a set of attachments.

Comments

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

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

en-AU


Mappings
  • rim: n/a
  • rim: ./language
DocumentReference.content.attachment.data
DefinitionThe actual data of the attachment - a sequence of bytes, base64 encoded.
Cardinality1...1
Typebase64Binary
Requirements

The data needs to able to be transmitted inline.

Comments

The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: ED.5
  • rim: ./data
DocumentReference.content.attachment.url
DefinitionA location where the data can be accessed.
Cardinality0...1
Typeurl
SummaryTrue
Requirements

The data needs to be transmitted by reference.

Comments

If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data.

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

http://www.acme.com/logo-small.png


Mappings
  • rim: n/a
  • v2: RP.1+RP.2 - if they refer to a URL (see v2.6)
  • rim: ./reference/literal
DocumentReference.content.attachment.size
DefinitionThe number of bytes of data that make up this attachment (before base64 encoding, if that is done).
Cardinality1...1
Typeinteger64
SummaryTrue
Requirements

Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all.

Comments

The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A (needs data type R3 proposal)
DocumentReference.content.attachment.hash
DefinitionThe calculated hash of the data using SHA-1. Represented using base64.
Cardinality0...1
Typebase64Binary
SummaryTrue
Requirements

Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version).

Comments

The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .integrityCheck[parent::ED/integrityCheckAlgorithm="SHA-1"]
DocumentReference.content.attachment.title
DefinitionA label or set of text to display in place of the data.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer.

Comments

May sometimes be derived from the source filename.

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

Official Corporate Logo


Mappings
  • rim: n/a
  • rim: ./title/data
DocumentReference.content.attachment.creation
DefinitionThe date that the attachment was first created.
Cardinality0...1
TypedateTime
SummaryTrue
Requirements

This is often tracked as an integrity issue for use of the attachment.

Comments

UTC offset is allowed for dates and partial dates

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A (needs data type R3 proposal)
DocumentReference.content.attachment.height
DefinitionHeight of the image in pixels (photo/video).
Cardinality0...0
TypepositiveInt
Comments

32 bit number; for values larger than this, use decimal

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="OBS", moodCode="EVN",code="<CODE>"].value
DocumentReference.content.attachment.width
DefinitionWidth of the image in pixels (photo/video).
Cardinality0...0
TypepositiveInt
Comments

32 bit number; for values larger than this, use decimal

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="OBS", moodCode="EVN",code="<CODE>"].value
DocumentReference.content.attachment.frames
DefinitionThe number of frames in a photo. This is used with a multi-page fax, or an imaging acquisition context that takes multiple slices in a single image, or an animated gif. If there is more than one frame, this SHALL have a value in order to alert interface software that a multi-frame capable rendering widget is required.
Cardinality0...0
TypepositiveInt
Comments

if the number of frames is not supplied, the value may be unknown. Applications should not assume that there is only one frame unless it is explicitly stated.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="OBS", moodCode="EVN",code="<CODE>"].value
DocumentReference.content.attachment.duration
DefinitionThe duration of the recording in seconds - for audio and video.
Cardinality0...0
Typedecimal
Comments

The duration might differ from occurrencePeriod if recording was paused.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="OBS", moodCode="EVN",code="<CODE>"].value
DocumentReference.content.attachment.pages
DefinitionThe number of pages when printed.
Cardinality0...1
TypepositiveInt
Comments

32 bit number; for values larger than this, use decimal

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
DocumentReference.content.profile
DefinitionAn identifier of the document constraints, encoding, structure, and template that the document conforms to beyond the base format indicated in the mimeType.
Cardinality0...0
TypeBackboneElement
SummaryTrue
Aliasformat, formatCode
Comments

Note that IHE often issues URNs for formatCode codes, not all documents can be identified by a URI.

For FHIR content, .profile should indicate the structureDefinition profile canonical URI(s) that the content complies with.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • fhircomposition: Composition.meta.profile
  • rim: document.text
  • xds: DocumentEntry.formatCode
  • cda: derived from the IHE Profile or Implementation Guide templateID
DocumentReference.content.profile.id
DefinitionUnique 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
DocumentReference.content.profile.extension
DefinitionMay 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 managable, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DocumentReference.content.profile.modifierExtension
DefinitionMay 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 managable, 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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
DocumentReference.content.profile.value[x]
DefinitionCode|uri|canonical.
Cardinality1...1
TypeCoding
Binding

Document Format Codes.

http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes (preferred)
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • fhircomposition: Composition.meta.profile
  • rim: document.text
  • xds: DocumentEntry.formatCode
  • cda: derived from the IHE Profile or Implementation Guide templateID
This is the resource in XML:
<StructureDefinition xmlns="http://hl7.org/fhir">
    <text>
        <status value="generated" />
        --- We have skipped the narrative for better readability of the resource ---
    </text>
    <url value="https://luxith-etab.org/fhir/StructureDefinition/lu/LuxithDocumentReferenceProfile" />
    <name value="LuxithDocumentReferenceProfile" />
    <status value="draft" />
    <fhirVersion value="5.0.0" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="DocumentReference" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DocumentReference" />
    <derivation value="constraint" />
    <differential>
        <element id="DocumentReference.identifier">
            <path value="DocumentReference.identifier" />
            <slicing>
                <discriminator>
                    <type value="pattern" />
                    <path value="$this" />
                </discriminator>
                <rules value="open" />
            </slicing>
        </element>
        <element id="DocumentReference.version">
            <path value="DocumentReference.version" />
            <max value="0" />
        </element>
        <element id="DocumentReference.basedOn">
            <path value="DocumentReference.basedOn" />
            <max value="0" />
        </element>
        <element id="DocumentReference.docStatus">
            <path value="DocumentReference.docStatus" />
            <min value="1" />
        </element>
        <element id="DocumentReference.modality">
            <path value="DocumentReference.modality" />
            <max value="0" />
        </element>
        <element id="DocumentReference.type">
            <path value="DocumentReference.type" />
            <min value="1" />
        </element>
        <element id="DocumentReference.type.coding">
            <path value="DocumentReference.type.coding" />
            <min value="1" />
            <max value="1" />
        </element>
        <element id="DocumentReference.type.coding.system">
            <path value="DocumentReference.type.coding.system" />
            <max value="0" />
        </element>
        <element id="DocumentReference.type.coding.version">
            <path value="DocumentReference.type.coding.version" />
            <max value="0" />
        </element>
        <element id="DocumentReference.type.coding.code">
            <path value="DocumentReference.type.coding.code" />
            <code>
                <system value="http://loinc.org" />
            </code>
        </element>
        <element id="DocumentReference.type.coding.display">
            <path value="DocumentReference.type.coding.display" />
            <max value="0" />
        </element>
        <element id="DocumentReference.type.coding.userSelected">
            <path value="DocumentReference.type.coding.userSelected" />
            <max value="0" />
        </element>
        <element id="DocumentReference.type.text">
            <path value="DocumentReference.type.text" />
            <min value="1" />
        </element>
        <element id="DocumentReference.category">
            <path value="DocumentReference.category" />
            <max value="0" />
        </element>
        <element id="DocumentReference.category.coding.system">
            <path value="DocumentReference.category.coding.system" />
            <max value="0" />
        </element>
        <element id="DocumentReference.category.coding.version">
            <path value="DocumentReference.category.coding.version" />
            <max value="0" />
        </element>
        <element id="DocumentReference.category.coding.userSelected">
            <path value="DocumentReference.category.coding.userSelected" />
            <max value="0" />
        </element>
        <element id="DocumentReference.category.text">
            <path value="DocumentReference.category.text" />
            <min value="1" />
        </element>
        <element id="DocumentReference.event">
            <path value="DocumentReference.event" />
            <max value="1" />
        </element>
        <element id="DocumentReference.bodySite">
            <path value="DocumentReference.bodySite" />
            <max value="0" />
        </element>
        <element id="DocumentReference.facilityType.coding">
            <path value="DocumentReference.facilityType.coding" />
            <max value="0" />
        </element>
        <element id="DocumentReference.facilityType.text">
            <path value="DocumentReference.facilityType.text" />
            <min value="1" />
        </element>
        <element id="DocumentReference.practiceSetting">
            <path value="DocumentReference.practiceSetting" />
            <max value="0" />
        </element>
        <element id="DocumentReference.period">
            <path value="DocumentReference.period" />
            <max value="0" />
        </element>
        <element id="DocumentReference.author">
            <path value="DocumentReference.author" />
            <max value="1" />
        </element>
        <element id="DocumentReference.attester">
            <path value="DocumentReference.attester" />
            <max value="0" />
        </element>
        <element id="DocumentReference.relatesTo">
            <path value="DocumentReference.relatesTo" />
            <max value="0" />
        </element>
        <element id="DocumentReference.securityLabel">
            <path value="DocumentReference.securityLabel" />
            <max value="1" />
        </element>
        <element id="DocumentReference.content.extension">
            <path value="DocumentReference.content.extension" />
            <requirements value="This extension holds an AES key that has been encrypted with an RSA public key" />
            <max value="1" />
        </element>
        <element id="DocumentReference.content.modifierExtension">
            <path value="DocumentReference.content.modifierExtension" />
            <max value="0" />
        </element>
        <element id="DocumentReference.content.attachment.contentType">
            <path value="DocumentReference.content.attachment.contentType" />
            <min value="1" />
        </element>
        <element id="DocumentReference.content.attachment.language">
            <path value="DocumentReference.content.attachment.language" />
            <max value="0" />
        </element>
        <element id="DocumentReference.content.attachment.data">
            <path value="DocumentReference.content.attachment.data" />
            <min value="1" />
        </element>
        <element id="DocumentReference.content.attachment.size">
            <path value="DocumentReference.content.attachment.size" />
            <min value="1" />
        </element>
        <element id="DocumentReference.content.attachment.height">
            <path value="DocumentReference.content.attachment.height" />
            <max value="0" />
        </element>
        <element id="DocumentReference.content.attachment.width">
            <path value="DocumentReference.content.attachment.width" />
            <max value="0" />
        </element>
        <element id="DocumentReference.content.attachment.frames">
            <path value="DocumentReference.content.attachment.frames" />
            <max value="0" />
        </element>
        <element id="DocumentReference.content.attachment.duration">
            <path value="DocumentReference.content.attachment.duration" />
            <max value="0" />
        </element>
        <element id="DocumentReference.content.profile">
            <path value="DocumentReference.content.profile" />
            <max value="0" />
        </element>
    </differential>
</StructureDefinition>
This is the resource in JSON:
{
    "resourceType": "StructureDefinition",
    "text": {
        "status": "generated",
        --- We have skipped the narrative for better readability of the resource ---
    },
    "url": "https://luxith-etab.org/fhir/StructureDefinition/lu/LuxithDocumentReferenceProfile",
    "name": "LuxithDocumentReferenceProfile",
    "status": "draft",
    "fhirVersion": "5.0.0",
    "kind": "resource",
    "abstract": false,
    "type": "DocumentReference",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/DocumentReference",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "DocumentReference.identifier",
                "path": "DocumentReference.identifier",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "pattern",
                            "path": "$this"
                        }
                    ],
                    "rules": "open"
                }
            },
            {
                "id": "DocumentReference.version",
                "path": "DocumentReference.version",
                "max": "0"
            },
            {
                "id": "DocumentReference.basedOn",
                "path": "DocumentReference.basedOn",
                "max": "0"
            },
            {
                "id": "DocumentReference.docStatus",
                "path": "DocumentReference.docStatus",
                "min": 1
            },
            {
                "id": "DocumentReference.modality",
                "path": "DocumentReference.modality",
                "max": "0"
            },
            {
                "id": "DocumentReference.type",
                "path": "DocumentReference.type",
                "min": 1
            },
            {
                "id": "DocumentReference.type.coding",
                "path": "DocumentReference.type.coding",
                "min": 1,
                "max": "1"
            },
            {
                "id": "DocumentReference.type.coding.system",
                "path": "DocumentReference.type.coding.system",
                "max": "0"
            },
            {
                "id": "DocumentReference.type.coding.version",
                "path": "DocumentReference.type.coding.version",
                "max": "0"
            },
            {
                "id": "DocumentReference.type.coding.code",
                "path": "DocumentReference.type.coding.code",
                "code":  [
                    {
                        "system": "http://loinc.org"
                    }
                ]
            },
            {
                "id": "DocumentReference.type.coding.display",
                "path": "DocumentReference.type.coding.display",
                "max": "0"
            },
            {
                "id": "DocumentReference.type.coding.userSelected",
                "path": "DocumentReference.type.coding.userSelected",
                "max": "0"
            },
            {
                "id": "DocumentReference.type.text",
                "path": "DocumentReference.type.text",
                "min": 1
            },
            {
                "id": "DocumentReference.category",
                "path": "DocumentReference.category",
                "max": "0"
            },
            {
                "id": "DocumentReference.category.coding.system",
                "path": "DocumentReference.category.coding.system",
                "max": "0"
            },
            {
                "id": "DocumentReference.category.coding.version",
                "path": "DocumentReference.category.coding.version",
                "max": "0"
            },
            {
                "id": "DocumentReference.category.coding.userSelected",
                "path": "DocumentReference.category.coding.userSelected",
                "max": "0"
            },
            {
                "id": "DocumentReference.category.text",
                "path": "DocumentReference.category.text",
                "min": 1
            },
            {
                "id": "DocumentReference.event",
                "path": "DocumentReference.event",
                "max": "1"
            },
            {
                "id": "DocumentReference.bodySite",
                "path": "DocumentReference.bodySite",
                "max": "0"
            },
            {
                "id": "DocumentReference.facilityType.coding",
                "path": "DocumentReference.facilityType.coding",
                "max": "0"
            },
            {
                "id": "DocumentReference.facilityType.text",
                "path": "DocumentReference.facilityType.text",
                "min": 1
            },
            {
                "id": "DocumentReference.practiceSetting",
                "path": "DocumentReference.practiceSetting",
                "max": "0"
            },
            {
                "id": "DocumentReference.period",
                "path": "DocumentReference.period",
                "max": "0"
            },
            {
                "id": "DocumentReference.author",
                "path": "DocumentReference.author",
                "max": "1"
            },
            {
                "id": "DocumentReference.attester",
                "path": "DocumentReference.attester",
                "max": "0"
            },
            {
                "id": "DocumentReference.relatesTo",
                "path": "DocumentReference.relatesTo",
                "max": "0"
            },
            {
                "id": "DocumentReference.securityLabel",
                "path": "DocumentReference.securityLabel",
                "max": "1"
            },
            {
                "id": "DocumentReference.content.extension",
                "path": "DocumentReference.content.extension",
                "requirements": "This extension holds an AES key that has been encrypted with an RSA public key",
                "max": "1"
            },
            {
                "id": "DocumentReference.content.modifierExtension",
                "path": "DocumentReference.content.modifierExtension",
                "max": "0"
            },
            {
                "id": "DocumentReference.content.attachment.contentType",
                "path": "DocumentReference.content.attachment.contentType",
                "min": 1
            },
            {
                "id": "DocumentReference.content.attachment.language",
                "path": "DocumentReference.content.attachment.language",
                "max": "0"
            },
            {
                "id": "DocumentReference.content.attachment.data",
                "path": "DocumentReference.content.attachment.data",
                "min": 1
            },
            {
                "id": "DocumentReference.content.attachment.size",
                "path": "DocumentReference.content.attachment.size",
                "min": 1
            },
            {
                "id": "DocumentReference.content.attachment.height",
                "path": "DocumentReference.content.attachment.height",
                "max": "0"
            },
            {
                "id": "DocumentReference.content.attachment.width",
                "path": "DocumentReference.content.attachment.width",
                "max": "0"
            },
            {
                "id": "DocumentReference.content.attachment.frames",
                "path": "DocumentReference.content.attachment.frames",
                "max": "0"
            },
            {
                "id": "DocumentReference.content.attachment.duration",
                "path": "DocumentReference.content.attachment.duration",
                "max": "0"
            },
            {
                "id": "DocumentReference.content.profile",
                "path": "DocumentReference.content.profile",
                "max": "0"
            }
        ]
    }
}