• dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
  contained.contained.empty()
• dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative
  contained.text.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
  contained.where(('#'+id in %resource.descendants().reference).not()).empty()

• rim: Entity. Role, or Act
• rim: Device
• w5: administrative.device

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

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

• rim: n/a

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

• rim: n/a
• rim: N/A

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

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

• rim: n/a

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

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

• rim: n/a

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

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

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

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

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

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

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

• rim: n/a
• rim: N/A

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

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

• rim: n/a
• rim: N/A

The barcode string from a barcode present on a device label or package may identify the instance, include names given to the device in local usage, or may identify the type of device. If the identifier identifies the type of device, Device.type element should be used. For UDI, this element corresponds to the variable portion of the UDI that identifies the serial number of a specific device. See UDI mappings for a complete mapping of UDI parts to Device.

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

• rim: n/a
• v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
• rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. 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
• udi: The serial number which is a component of the production identifier (PI), a conditional, variable portion of a UDI. The identifier.type code should be set to “SNO”(Serial Number) and the system left empty.
• rim: .id
• w5: id

UDI may identify an unique instance of a device, or it may only identify the type of the device. See UDI mappings for a complete mapping of UDI parts to Device.

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

• rim: n/a
• rim: .id and .code
• w5: id

Note that FHIR strings may not exceed 1MB in size

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

• rim: n/a

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

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

• rim: n/a
• rim: N/A

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

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

• rim: n/a
• rim: N/A

Note that FHIR strings may not exceed 1MB in size

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

• rim: n/a
• udi: The device identifier (DI), a mandatory, fixed portion of a UDI that identifies the labeler and the specific version or model of a device.
• rim: Role.id.extension
• w5: what

Use the Device.type for a generic type or kind of device name. Note the GUDID lists the name as the 'Brand Name'.

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

• rim: n/a
• udi: Propietary/Trade Name of the medical Device as used in the labeling or catalog
• rim: .displayName
• w5: what

Allows a recipient of a UDI to know which database will contain the UDI-associated metadata.

see http://en.wikipedia.org/wiki/Uniform_resource_identifier

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

• rim: n/a
• rim: Role.scoper

If separate barcodes for DI and PI are present, concatenate the string with DI first and in order of human readable expression on label.

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

• rim: n/a
• udi: A unique device identifier (UDI) on a device label in plain text
• rim: Role.id.extension

The AIDC form of UDIs should be scanned or otherwise used for the identification of the device whenever possible to minimize errors in records resulting from manual transcriptions. If separate barcodes for DI and PI are present, concatenate the string with DI first and in order of human readable expression on label.

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

• rim: n/a
• udi: A unique device identifier (UDI) on a device label a form that uses automatic identification and data capture (AIDC) technology.
• rim: Role.id.extension

see http://en.wikipedia.org/wiki/Uniform_resource_identifier

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

• rim: n/a
• udi: All UDIs are to be issued under a system operated by an Jurisdiction-accredited issuing agency. GS1 DIs: http://hl7.org/fhir/NamingSystem/gs1 HIBCC DIs: http://hl7.org/fhir/NamingSystem/hibcc ICCBBA DIs for blood containers: http://hl7.org/fhir/NamingSystem/iccbba-blood ICCBA DIs for other devices: http://hl7.org/fhir/NamingSystem/iccbba-other
• rim: Role.id.root

Supports a way to distinguish hand entered from machine read data.

Note that FHIR strings may not exceed 1MB in size

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

• rim: n/a
• rim: NA

This element is labeled as a modifier because the status contains the codes inactive and entered-in-error that mark the device (record)as not currently valid.

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

active

• rim: n/a
• rim: .statusCode
• w5: status
• ACSPIX2FHIR: active
• GREENDOT: active
• CDF2FHIR: active

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

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

• rim: n/a
• v2: CE/CNE/CWE
• rim: CD
• orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
• udi: Type description using GMDN or other code system
• rim: .code
• w5: what
• GLUCI-CHEK: Software

Note that FHIR strings may not exceed 1MB in size

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

• rim: n/a

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

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

• rim: n/a
• rim: N/A

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

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

• 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

Note that FHIR strings may not exceed 1MB in size

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

• rim: n/a

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

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

• rim: n/a
• rim: N/A

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

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 de-reference to some definition that establish the system clearly and unambiguously.

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

• rim: n/a
• v2: C*E.3
• rim: ./codeSystem
• orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
• ACSPIX2FHIR: http://roche.com/fhir/rdc/cdf
• GREENDOT: http://roche.com/fhir/rdc/cdf
• CDF2FHIR: http://roche.com/fhir/rdc/cdf

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

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

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

Need to refer to a particular code in the system.

Note that FHIR strings may not exceed 1MB in size

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

• rim: n/a
• v2: C*E.1
• rim: ./code
• orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
• ACSPIX2FHIR: cdf.dev.im
• GREENDOT: cdf.dev.im
• CDF2FHIR: cdf.dev.im

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

Note that FHIR strings may not exceed 1MB in size

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

• 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
• ACSPIX2FHIR: Manual interface
• GREENDOT: Manual interface
• CDF2FHIR: Manual interface

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

• 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 ]

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.

Very often the text is the same as a displayName of one of the codings.

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

• 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

Note that FHIR strings may not exceed 1MB in size

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

• rim: n/a
• udi: The lot or batch number within which a device was manufactured - which is a component of the production identifier (PI), a conditional, variable portion of a UDI.
• rim: .lotNumberText
• w5: what

Actual options: "Roche" and "mySugr"

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

• rim: n/a
• udi: N/A
• rim: .playedRole[typeCode=MANU].scoper.name
• w5: what
• ACSPIX2FHIR: Roche
• GREENDOT: Roche
• CDF2FHIR: Roche

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

• rim: n/a
• udi: The date a specific device was manufactured - which is a component of the production identifier (PI), a conditional, variable portion of a UDI. For FHIR, The datetime syntax must converted to YYYY-MM-DD[THH:MM:SS]. If hour is present, the minutes and seconds should both be set to “00”.
• rim: .existenceTime.low
• w5: what

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

• rim: n/a
• udi: the expiration date of a specific device - which is a component of the production identifier (PI), a conditional, variable portion of a UDI. For FHIR, The datetime syntax must converted to YYYY-MM-DD[THH:MM:SS]. If hour is present, the minutes and seconds should both be set to “00”.
• rim: .expirationTime
• w5: what

Note that FHIR strings may not exceed 1MB in size

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

• rim: n/a
• rim: .playedRole[typeCode=MANU].code
• w5: what
• ACSPIX2FHIR: source
• GREENDOT: GreenDot
• GLUCI-CHEK: ACSPIX.SN
• CDF2FHIR: source

Note that FHIR strings may not exceed 1MB in size

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

• rim: n/a
• rim: .softwareName (included as part)
• w5: what
• ACSPIX2FHIR: version
• GREENDOT: software version
• GLUCI-CHEK: ACSPIX.Ver
• CDF2FHIR: version

If the device is implanted in a patient, then need to associate the device to the patient.

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

• ele-1: All FHIR elements must have a @value or children
  hasValue() | (children().count() > id.count())
• ref-1: SHALL have a contained resource if a local reference is provided
  reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

• rim: n/a
• rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
• rim: .playedRole[typeCode=USED].scoper.playedRole[typeCode=PAT]
• w5: who.focus

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

• ele-1: All FHIR elements must have a @value or children
  hasValue() | (children().count() > id.count())
• ref-1: SHALL have a contained resource if a local reference is provided
  reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

• rim: n/a
• rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
• rim: .playedRole[typeCode=OWN].scoper
• w5: who.source

used for troubleshooting etc.

• ele-1: All FHIR elements must have a @value or children
  hasValue() | (children().count() > id.count())
• cpt-2: A system is required if a value is provided.
  value.empty() or system.exists()

• rim: n/a
• v2: XTN
• rim: TEL
• servd: ContactPoint
• rim: .scopedRole[typeCode=CON].player
• w5: who.source

Device.location can be used to track device location.

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

• ele-1: All FHIR elements must have a @value or children
  hasValue() | (children().count() > id.count())
• ref-1: SHALL have a contained resource if a local reference is provided
  reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

• rim: n/a
• rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
• rim: .playedRole[typeCode=LOCE].scoper
• w5: where

If the device is running a FHIR server, the network address should be the Base URL from which a conformance statement may be retrieved.

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

• rim: n/a
• rim: .telecom
• w5: where

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

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

• rim: n/a
• v2: N/A
• rim: Act
• rim: .text

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

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

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