ServiceRequest

ServiceRequest creates an order with all neccessary informations.

Create

Endpoint

POST <serveraddress>/fhir/ServiceRequest

This returns the created ServiceRequest and an url in the location header.

All CodeableConcepts are bound to an individual CodeSystem. ValueSet can be used to query these codes.

Patient, Condition, Medication and Specimens shall be submitted as contained resources.

Notification

To get information about the status of the process, an notification url can be submitted in an extension.
At each workflow step, the current DiagnosticReport is sent to this URL.

Structures

ServiceRequest

ServiceRequestCreate (ServiceRequest)	I		ServiceRequest	There are no (further) constraints on this element Element id ServiceRequest Short description A request for a service to be performed Alternate names diagnostic request, referral, referral request, transfer of care request Definition A record of a request for service such as diagnostic investigations, treatments, or operations to be performed. Data type ServiceRequest Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() prr-1: orderDetail SHALL only be present if code is present `orderDetail.empty() or code.exists()` Mappings rim: Entity. Role, or Act workflow: Request v2: ORC rim: Act[moodCode<=INT]
id	Σ	0..1	string	There are no (further) constraints on this element Element id ServiceRequest.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id ServiceRequest.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id ServiceRequest.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id ServiceRequest.language Short description Language of the resource content Definition The base language in which the resource is written. 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id ServiceRequest.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		1..*	Resource	Element id ServiceRequest.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. 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. Data type Resource Sliced: Unordered, Closed, by Mappings rim: N/A
PatientCreate		1..1	Resource	There are no (further) constraints on this element Element id ServiceRequest.contained:PatientCreate Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. 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. Data type Resource Mappings rim: N/A
ConditionCreate		0..1	Resource	There are no (further) constraints on this element Element id ServiceRequest.contained:ConditionCreate Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. 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. Data type Resource Mappings rim: N/A
MedicationCreate		0..1	Resource	There are no (further) constraints on this element Element id ServiceRequest.contained:MedicationCreate Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. 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. Data type Resource Mappings rim: N/A
SpecimenCreate		0..*	Resource	There are no (further) constraints on this element Element id ServiceRequest.contained:SpecimenCreate Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. 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. Data type Resource Mappings rim: N/A
extension	I	0..1	Extension	Element id ServiceRequest.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
NotificationUrl	I	0..1	Extension(url)	Element id ServiceRequest.extension:NotificationUrl Short description Optional Extensions Element Alternate names extensions, user content Definition An URL to get notifications. At each workflow step, the current 'DiagnosticReport' resource is sent to this URL. 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. Data type Extension(url) Extension URL http://www.qualitype.de/samples/fhir/StructureDefinition/notification-url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A rim: n/a
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id ServiceRequest.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id ServiceRequest.identifier Short description Identifiers assigned to this order Definition Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller. Comments The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.identifier w5: FiveWs.identifier v2: ORC.2, ORC.3, RF1-6 / RF1-11, rim: .identifier quick: ClinicalStatement.identifier
instantiatesCanonical	Σ	0..0	canonical(ActivityDefinition \| PlanDefinition)	There are no (further) constraints on this element Element id ServiceRequest.instantiatesCanonical Short description Instantiates FHIR protocol or definition Definition The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest. Comments Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. Data type canonical(ActivityDefinition \| PlanDefinition) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.instantiatesCanonical v2: Varies by domain rim: .outboundRelationship[typeCode=DEFN].target
instantiatesUri	Σ	0..0	uri	There are no (further) constraints on this element Element id ServiceRequest.instantiatesUri Short description Instantiates external protocol or definition Definition The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest. Comments This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.instantiatesUri v2: Varies by domain rim: .outboundRelationship[typeCode=DEFN].target
basedOn	Σ	0..0	Reference(CarePlan \| ServiceRequest \| MedicationRequest)	There are no (further) constraints on this element Element id ServiceRequest.basedOn Short description What request fulfills Alternate names fulfills Definition Plan/proposal/order fulfilled by this request. Data type Reference(CarePlan \| ServiceRequest \| MedicationRequest) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.basedOn v2: ORC.8 (plus others) rim: .outboundRelationship[typeCode=FLFS].target
replaces	Σ	0..0	Reference(ServiceRequest)	There are no (further) constraints on this element Element id ServiceRequest.replaces Short description What request replaces Alternate names supersedes, prior, renewed order Definition The request takes the place of the referenced completed or terminated request(s). Data type Reference(ServiceRequest) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.replaces v2: Handled by message location of ORC (ORC.1=RO or RU) rim: .outboundRelationship[typeCode=RPLC].target
requisition	Σ	0..0	Identifier	There are no (further) constraints on this element Element id ServiceRequest.requisition Short description Composite Request ID Alternate names grouperId, groupIdentifier Definition A shared identifier common to all service requests that were authorized more or less simultaneously by a single author, representing the composite or group identifier. Requirements Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes. Comments Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.groupIdentifier v2: ORC.4 rim: .inboundRelationship(typeCode=COMP].source[moodCode=INT].identifier
status	Σ ?!	1..1	codeBindingPattern	Element id ServiceRequest.status Short description draft \| active \| on-hold \| revoked \| completed \| entered-in-error \| unknown Definition The status of the order. Comments The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource. Data type code Binding The status of a service order. RequestStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern active Mappings workflow: Request.status w5: FiveWs.status v2: ORC.5,RF1-1 rim: .status quick: Action.currentStatus
intent	Σ ?!	1..1	codeBindingPattern	Element id ServiceRequest.intent Short description proposal \| plan \| directive \| order \| original-order \| reflex-order \| filler-order \| instance-order \| option Definition Whether the request is a proposal, plan, an original order or a reflex order. Comments This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. Data type code Binding The kind of service request. RequestIntent (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern order Mappings workflow: Request.intent w5: FiveWs.class v2: N/A rim: .moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
category	Σ	0..0	CodeableConcept	There are no (further) constraints on this element Element id ServiceRequest.category Short description Classification of service Definition A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure"). Requirements Used for filtering what service request are retrieved and displayed. Comments There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set. Data type CodeableConcept Binding Classification of the requested service. ServiceRequestCategoryCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.class v2: RF1-5 rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="INT"].code
priority	Σ	0..0	codeBinding	There are no (further) constraints on this element Element id ServiceRequest.priority Short description routine \| urgent \| asap \| stat Definition Indicates how quickly the ServiceRequest should be addressed with respect to other requests. Meaning when missing If missing, this task should be performed with normal priority Data type code Binding Identifies the level of importance to be assigned to actioning the request. RequestPriority (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.priority w5: FiveWs.grade v2: TQ1.9, RF1-2 rim: .priorityCode
doNotPerform	Σ ?!	0..0	boolean	There are no (further) constraints on this element Element id ServiceRequest.doNotPerform Short description True if service/procedure should not be performed Definition Set this to true if the record is saying that the service/procedure should NOT be performed. Requirements Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc. Comments In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation. Meaning when missing If missing, the request is a positive request e.g. "do perform" Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.doNotPerform rim: .actionNegationInd
code	Σ	0..1	CodeableConceptBinding	Element id ServiceRequest.code Short description What is being requested/ordered Alternate names service requested Definition A code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested. Comments Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code. Data type CodeableConcept Binding Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is (preferred)[http://build.fhir.org/terminologies.html#preferred] and a valueset using LOINC Order codes is available here. http://www.qualitype.de/samples/fhir/CodeSystem/goals (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.code w5: FiveWs.what[x] v2: PR1-3 / OBR-4 (varies by domain) rim: .code quick: Procedure.procedureCode
id		0..1	string	There are no (further) constraints on this element Element id ServiceRequest.code.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id ServiceRequest.code.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
coding	Σ	0..1	Coding	There are no (further) constraints on this element Element id ServiceRequest.code.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
text	Σ	0..0	string	There are no (further) constraints on this element Element id ServiceRequest.code.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
orderDetail	Σ I	0..0	CodeableConcept	There are no (further) constraints on this element Element id ServiceRequest.orderDetail Short description Additional order information Alternate names detailed instructions Definition Additional details and instructions about the how the services are to be delivered. For example, and order for a urinary catheter may have an order detail for an external or indwelling catheter, or an order for a bandage may require additional instructions specifying how the bandage should be applied. Comments For information from the medical record intended to support the delivery of the requested services, use the `supportingInformation` element. Data type CodeableConcept Binding Codified order entry details which are based on order context. ServiceRequestOrderDetailsCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NTE rim: .code quick: Procedure.procedureCode
quantity[x]	Σ	0..0		There are no (further) constraints on this element Element id ServiceRequest.quantity[x] Short description Service amount Definition An amount of service being requested which can be a quantity ( for example $1,500 home modification), a ratio ( for example, 20 half day visits per month), or a range (2.0 to 1.8 Gy per fraction). Requirements When ordering a service the number of service items may need to be specified separately from the the service item. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NTE rim: .quantity
subject	Σ	1..1	Reference(PatientCreate)	Element id ServiceRequest.subject Short description Individual or Entity the service is ordered for Definition On whom or what the service is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans). Data type Reference(PatientCreate) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.subject w5: FiveWs.subject[x] v2: PID rim: .participation[typeCode=SBJ].role quick: ClinicalStatement.subject w5: FiveWs.subject
encounter	Σ	0..0	Reference(Encounter)	There are no (further) constraints on this element Element id ServiceRequest.encounter Short description Encounter in which the request was created Alternate names context Definition An encounter that provides additional information about the healthcare context in which this request is made. Data type Reference(Encounter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.encounter w5: FiveWs.context v2: PV1 rim: .inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN] quick: ClinicalStatement.encounter
occurrence[x]	Σ	0..0		There are no (further) constraints on this element Element id ServiceRequest.occurrence[x] Short description When service should occur Alternate names schedule Definition The date/time at which the requested service should occur. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.occurrence[x] w5: FiveWs.planned v2: TQ1/TQ2, OBR-7/OBR-8 rim: .effectiveTime quick: Procedure.procedureSchedule
asNeeded[x]	Σ	0..0		There are no (further) constraints on this element Element id ServiceRequest.asNeeded[x] Short description Preconditions for service Definition If a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc. Binding A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. SNOMEDCTMedicationAsNeededReasonCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: boolean: precondition.negationInd (inversed - so negationInd = true means asNeeded=false CodeableConcept: precondition.observationEventCriterion[code="Assertion"].value quick: Proposal.prnReason.reason
authoredOn	Σ	0..0	dateTime	There are no (further) constraints on this element Element id ServiceRequest.authoredOn Short description Date request signed Alternate names orderedOn Definition When the request transitioned to being actionable. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.authoredOn w5: FiveWs.recorded v2: ORC.9, RF1-7 / RF1-9 rim: .participation[typeCode=AUT].time quick: Proposal.proposedAtTime
requester	Σ	0..1	Reference(Organization)	Element id ServiceRequest.requester Short description Who/what is requesting service Alternate names author, orderer Definition The individual who initiated the request and has responsibility for its activation. Comments This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.requester w5: FiveWs.author v2: ORC.12, PRT rim: .participation[typeCode=AUT].role quick: ClinicalStatement.statementAuthor
performerType	Σ	0..0	CodeableConcept	There are no (further) constraints on this element Element id ServiceRequest.performerType Short description Performer role Alternate names specialty Definition Desired type of performer for doing the requested service. Comments This is a role, not a participation type. In other words, does not describe the task but describes the capacity. For example, “compounding pharmacy”, “psychiatrist” or “internal referral”. Data type CodeableConcept Binding Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. ParticipantRoles (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.performerType w5: FiveWs.actor v2: PRT, RF!-3 rim: .participation[typeCode=PRF].role[scoper.determinerCode=KIND].code
performer	Σ	0..0	Reference(Practitioner \| PractitionerRole \| Organization \| CareTeam \| HealthcareService \| Patient \| Device \| RelatedPerson)	There are no (further) constraints on this element Element id ServiceRequest.performer Short description Requested performer Alternate names request recipient Definition The desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc. Comments If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B). Data type Reference(Practitioner \| PractitionerRole \| Organization \| CareTeam \| HealthcareService \| Patient \| Device \| RelatedPerson) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.performer w5: FiveWs.actor v2: PRT, Practitioner: PRD-2/PRD-7 where PRD-3 = RT; Organization: PRD-10 where PRD-3 = RT rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
locationCode	Σ	0..0	CodeableConcept	There are no (further) constraints on this element Element id ServiceRequest.locationCode Short description Requested location Definition The preferred location(s) where the procedure should actually happen in coded or free text form. E.g. at home or nursing day care center. Data type CodeableConcept Binding A location type where services are delivered. v3.ServiceDeliveryLocationRoleType (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.actor rim: .participation[typeCode=LOC].role[scoper.determinerCode=KIND].code
locationReference	Σ	0..0	Reference(Location)	There are no (further) constraints on this element Element id ServiceRequest.locationReference Short description Requested location Definition A reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center. Data type Reference(Location) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.actor rim: .participation[typeCode=LOC].role[scoper.determinerCode=INSTANCE]
reasonCode	Σ	0..1	CodeableConceptBinding	Element id ServiceRequest.reasonCode Short description Explanation/Justification for procedure or service Definition An explanation or justification for why this service is being requested in coded or textual form. This is often for billing purposes. May relate to the resources referred to in `supportingInfo`. Comments This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use `CodeableConcept.text` element if the data is free (uncoded) text as shown in the CT Scan example. Data type CodeableConcept Binding Diagnosis or problem codes justifying the reason for requesting the service investigation. http://www.qualitype.de/samples/fhir/CodeSystem/indications (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.reasonCode w5: FiveWs.why[x] v2: ORC.16, RF1-10 rim: .reasonCode
id		0..1	string	There are no (further) constraints on this element Element id ServiceRequest.reasonCode.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id ServiceRequest.reasonCode.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
coding	Σ	0..1	Coding	There are no (further) constraints on this element Element id ServiceRequest.reasonCode.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
text	Σ	0..0	string	There are no (further) constraints on this element Element id ServiceRequest.reasonCode.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
reasonReference	Σ	0..0	Reference(Condition \| Observation \| DiagnosticReport \| DocumentReference)	There are no (further) constraints on this element Element id ServiceRequest.reasonReference Short description Explanation/Justification for service or service Definition Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in `supportingInfo`. Comments This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in `DiagnosticReport.conclusion` and/or `DiagnosticReport.conclusionCode`. When using a reference to DocumentReference, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in `ServiceRequest.reasonCode` if the data is free (uncoded) text as shown in the CT Scan example. Data type Reference(Condition \| Observation \| DiagnosticReport \| DocumentReference) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.reasonReference w5: FiveWs.why[x] v2: ORC.16 rim: .outboundRelationship[typeCode=RSON].target
insurance		0..0	Reference(Coverage \| ClaimResponse)	There are no (further) constraints on this element Element id ServiceRequest.insurance Short description Associated insurance coverage Definition Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service. Data type Reference(Coverage \| ClaimResponse) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.insurance v2: IN1/IN2 rim: .outboundRelationship[typeCode=COVBY].target
supportingInfo		0..2	Reference(ConditionCreate \| MedicationCreate)	Element id ServiceRequest.supportingInfo Short description Additional clinical information Alternate names Ask at order entry question, AOE Definition Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements. Comments To represent information about how the services are to be delivered use the `instructions` element. Data type Reference(ConditionCreate \| MedicationCreate) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.supportingInfo v2: Accompanying segments rim: .outboundRelationship[typeCode=PERT].target
specimen	Σ	0..*	Reference(SpecimenCreate)	Element id ServiceRequest.specimen Short description Procedure Samples Definition One or more specimens that the laboratory procedure will use. Comments Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the Specimen resource points to the ServiceRequest. Data type Reference(SpecimenCreate) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SPM rim: .participation[typeCode=SPC].role
bodySite	Σ	0..0	CodeableConcept	There are no (further) constraints on this element Element id ServiceRequest.bodySite Short description Location on Body Alternate names location Definition Anatomic location where the procedure should be performed. This is the target site. Requirements Knowing where the procedure is performed is important for tracking if multiple sites are possible. Comments Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension procedure-targetBodyStructure. Data type CodeableConcept Binding Codes describing anatomical locations. May include laterality. SNOMEDCTBodyStructures (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SPM rim: targetSiteCode quick: Procedure.targetBodySite
note		0..0	Annotation	There are no (further) constraints on this element Element id ServiceRequest.note Short description Comments Definition Any other notes and comments made about the service request. For example, internal billing notes. Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.note v2: NTE rim: .inboundRelationship(typeCode=SUBJ].source[classCode=ANNGEN, moodCode=EVN].value[xsi:type=ST] quick: ClinicalStatement.additionalText
patientInstruction	Σ	0..0	string	There are no (further) constraints on this element Element id ServiceRequest.patientInstruction Short description Patient or consumer-oriented instructions Definition Instructions in terms that are understood by the patient or consumer. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NTE rim: .text
relevantHistory		0..0	Reference(Provenance)	There are no (further) constraints on this element Element id ServiceRequest.relevantHistory Short description Request provenance Definition Key events in the history of the request. Comments This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject. Data type Reference(Provenance) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.relevantHistory v2: N/A rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

Patient

PatientCreate (Patient)	I		Patient	There are no (further) constraints on this element Element id Patient Short description Information about an individual or animal receiving health care services Alternate names SubjectOfCare Client Resident Definition Demographics and other administrative information about an individual or animal receiving care or other health-related services. Data type Patient Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act rim: Patient[classCode=PAT] cda: ClinicalDocument.recordTarget.patientRole
id	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Patient.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Patient.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Patient.language Short description Language of the resource content Definition The base language in which the resource is written. 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id Patient.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Patient.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. 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. Data type Resource Mappings rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Patient.identifier Short description An identifier for this patient Definition An identifier for this patient. Requirements Patients are almost always assigned specific numerical identifiers. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier v2: PID-3 rim: id cda: .id
active	Σ ?!	0..0	boolean	There are no (further) constraints on this element Element id Patient.active Short description Whether this patient's record is in active use Definition Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules. It is often used to filter patient lists to exclude inactive patients Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death. Requirements Need to be able to mark a patient record as not to be used because it was created in error. Comments If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient. Meaning when missing This resource is generally assumed to be active if no value is provided for the active element Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.status rim: statusCode cda: n/a
name	Σ	0..0	HumanName	There are no (further) constraints on this element Element id Patient.name Short description A name associated with the patient Definition A name associated with the individual. Requirements Need to be able to track the patient by multiple names. Examples are your official name and a partner name. Comments A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns. Data type HumanName Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-5, PID-9 rim: name cda: .patient.name
telecom	Σ	0..0	ContactPoint	There are no (further) constraints on this element Element id Patient.telecom Short description A contact detail for the individual Definition A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. Requirements People have (primary) ways to contact them in some way such as phone, email. Comments A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone). Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-13, PID-14, PID-40 rim: telecom cda: .telecom
gender	Σ	0..0	codeBinding	There are no (further) constraints on this element Element id Patient.gender Short description male \| female \| other \| unknown Definition Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Requirements Needed for identification of the individual, in combination with (at least) name and birth date. Comments The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex. Data type code Binding The gender of a person used for administrative purposes. AdministrativeGender (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-8 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender cda: .patient.administrativeGenderCode
birthDate	Σ	0..0	date	There are no (further) constraints on this element Element id Patient.birthDate Short description The date of birth for the individual Definition The date of birth for the individual. Requirements Age of the individual drives many clinical processes. Comments At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems). Data type date Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-7 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/birthTime cda: .patient.birthTime loinc: 21112-8
deceased[x]	Σ ?!	0..0		There are no (further) constraints on this element Element id Patient.deceased[x] Short description Indicates if the individual is deceased or not Definition Indicates if the individual is deceased or not. Requirements The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. Comments If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-30 (bool) and PID-29 (datetime) rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedTime cda: n/a
address	Σ	0..0	Address	There are no (further) constraints on this element Element id Patient.address Short description An address for the individual Definition An address for the individual. Requirements May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Comments Patient may have multiple addresses with different uses or applicable periods. Data type Address Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-11 rim: addr cda: .addr
maritalStatus		0..0	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.maritalStatus Short description Marital (civil) status of a patient Definition This field contains a patient's most recent marital (civil) status. Requirements Most, if not all systems capture it. Data type CodeableConcept Binding The domestic partnership status of a person. Marital Status Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-16 rim: player[classCode=PSN]/maritalStatusCode cda: .patient.maritalStatusCode
multipleBirth[x]		0..0		There are no (further) constraints on this element Element id Patient.multipleBirth[x] Short description Whether patient is part of a multiple birth Definition Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). Requirements For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. Comments Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-24 (bool), PID-25 (integer) rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber cda: n/a
photo		0..0	Attachment	There are no (further) constraints on this element Element id Patient.photo Short description Image of the patient Definition Image of the patient. Requirements Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Comments Guidelines: Use id photos, not clinical photos. Limit dimensions to thumbnail. Keep byte count low to ease resource updates. Data type Attachment Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-5 - needs a profile rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/desc cda: n/a
contact	I	0..0	BackboneElement	There are no (further) constraints on this element Element id Patient.contact Short description A contact party (e.g. guardian, partner, friend) for the patient Definition A contact party (e.g. guardian, partner, friend) for the patient. Requirements Need to track people you can contact about the patient. Comments Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` pat-1: SHALL at least contain a contact's details or a reference to an organization `name.exists() or telecom.exists() or address.exists() or organization.exists()` Mappings rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON] cda: n/a
communication		0..0	BackboneElement	There are no (further) constraints on this element Element id Patient.communication Short description A language which may be used to communicate with the patient about his or her health Definition A language which may be used to communicate with the patient about his or her health. Requirements If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest. Comments If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: LanguageCommunication cda: patient.languageCommunication
generalPractitioner		0..0	Reference(Organization \| Practitioner \| PractitionerRole)	There are no (further) constraints on this element Element id Patient.generalPractitioner Short description Patient's nominated primary care provider Alternate names careProvider Definition Patient's nominated care provider. Comments This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. Data type Reference(Organization \| Practitioner \| PractitionerRole) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PD1-4 rim: subjectOf.CareEvent.performer.AssignedEntity cda: n/a
managingOrganization	Σ	0..0	Reference(Organization)	There are no (further) constraints on this element Element id Patient.managingOrganization Short description Organization that is the custodian of the patient record Definition Organization that is the custodian of the patient record. Requirements Need to know who recognizes this patient record, manages and updates it. Comments There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: scoper cda: .providerOrganization
link	Σ ?!	0..0	BackboneElement	There are no (further) constraints on this element Element id Patient.link Short description Link to another patient resource that concerns the same actual person Definition Link to another patient resource that concerns the same actual patient. Requirements There are multiple use cases: Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and Distribution of patient information across multiple servers. Comments There is no assumption that linked patient records have mutual links. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: outboundLink cda: n/a

Condition

ConditionCreate (Condition)	I		Condition	There are no (further) constraints on this element Element id Condition Short description Detailed information about conditions, problems or diagnoses Definition A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern. Data type Condition Constraints con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item `clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()` con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission `abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()` con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error `verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()` dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act workflow: Event sct-concept: < 243796009 \|Situation with explicit context\| : 246090004 \|Associated finding\| = ( ( < 404684003 \|Clinical finding\| MINUS ( << 420134006 \|Propensity to adverse reactions\| OR << 473010000 \|Hypersensitivity condition\| OR << 79899007 \|Drug interaction\| OR << 69449002 \|Drug action\| OR << 441742003 \|Evaluation finding\| OR << 307824009 \|Administrative status\| OR << 385356007 \|Tumor stage finding\|)) OR < 272379006 \|Event\|) v2: PPR message rim: Observation[classCode=OBS, moodCode=EVN, code=ASSERTION, value<Diagnosis]
id	Σ	0..1	string	There are no (further) constraints on this element Element id Condition.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Condition.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Condition.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Condition.language Short description Language of the resource content Definition The base language in which the resource is written. 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id Condition.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Condition.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. 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. Data type Resource Mappings rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Condition.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Condition.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier	Σ	0..0	Identifier	There are no (further) constraints on this element Element id Condition.identifier Short description External Ids for this condition Definition Business identifiers assigned to this condition by the performer or other systems which remain constant as the resource is updated and propagates from server to server. Requirements Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers. Comments This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.identifier w5: FiveWs.identifier rim: .id
clinicalStatus	Σ ?! I	0..0	CodeableConceptBinding	There are no (further) constraints on this element Element id Condition.clinicalStatus Short description active \| recurrence \| relapse \| inactive \| remission \| resolved Definition The clinical status of the condition. Comments The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity. Data type CodeableConcept Binding The clinical status of the condition or diagnosis. ConditionClinicalStatusCodes (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.status w5: FiveWs.status sct-concept: < 303105007 \|Disease phases\| v2: PRB-14 rim: Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="clinicalStatus", moodCode=EVN].value
verificationStatus	Σ ?! I	0..0	CodeableConceptBinding	There are no (further) constraints on this element Element id Condition.verificationStatus Short description unconfirmed \| provisional \| differential \| confirmed \| refuted \| entered-in-error Definition The verification status to support the clinical status of the condition. Comments verificationStatus is not required. For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status. The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity. Data type CodeableConcept Binding The verification status to support or decline the clinical status of the condition or diagnosis. ConditionVerificationStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.status w5: FiveWs.status sct-concept: < 410514004 \|Finding context value\| v2: PRB-13 rim: Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="verificationStatus", moodCode=EVN].value sct-attr: 408729009
category		0..0	CodeableConceptBinding	There are no (further) constraints on this element Element id Condition.category Short description problem-list-item \| encounter-diagnosis Definition A category assigned to the condition. Comments The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts. Data type CodeableConcept Binding A category assigned to the condition. ConditionCategoryCodes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.class sct-concept: < 404684003 \|Clinical finding\| v2: 'problem' if from PRB-3. 'diagnosis' if from DG1 segment in PV1 message rim: .code
severity		0..0	CodeableConceptBinding	There are no (further) constraints on this element Element id Condition.severity Short description Subjective severity of condition Definition A subjective assessment of the severity of the condition as evaluated by the clinician. Comments Coding of the severity with a terminology is preferred, where possible. Data type CodeableConcept Binding A subjective assessment of the severity of the condition as evaluated by the clinician. Condition/DiagnosisSeverity (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.grade sct-concept: < 272141005 \|Severities\| v2: PRB-26 / ABS-3 rim: Can be pre/post-coordinated into value. Or ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="severity"].value sct-attr: 246112005
code	Σ	0..1	CodeableConceptBinding	Element id Condition.code Short description Identification of the condition, problem or diagnosis Alternate names type Definition Identification of the condition, problem or diagnosis. Requirements 0..1 to account for primarily narrative only resources. Data type CodeableConcept Binding Identification of the condition or diagnosis. http://www.qualitype.de/samples/fhir/CodeSystem/diagnoses (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.code w5: FiveWs.what[x] sct-concept: code 246090004 \|Associated finding\| (< 404684003 \|Clinical finding\| MINUS << 420134006 \|Propensity to adverse reactions\| MINUS << 473010000 \|Hypersensitivity condition\| MINUS << 79899007 \|Drug interaction\| MINUS << 69449002 \|Drug action\| MINUS << 441742003 \|Evaluation finding\| MINUS << 307824009 \|Administrative status\| MINUS << 385356007 \|Tumor stage finding\|) OR < 413350009 \|Finding with explicit context\| OR < 272379006 \|Event\| v2: PRB-3 rim: .value sct-attr: 246090004
id		0..1	string	There are no (further) constraints on this element Element id Condition.code.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Condition.code.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
coding	Σ	0..1	Coding	There are no (further) constraints on this element Element id Condition.code.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
text	Σ	0..0	string	There are no (further) constraints on this element Element id Condition.code.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
bodySite	Σ	0..0	CodeableConcept	There are no (further) constraints on this element Element id Condition.bodySite Short description Anatomical location, if relevant Definition The anatomical location where this condition manifests itself. Comments Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both. Data type CodeableConcept Binding Codes describing anatomical locations. May include laterality. SNOMEDCTBodyStructures (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings sct-concept: < 442083009 \|Anatomical or acquired body structure\| rim: .targetBodySiteCode sct-attr: 363698007
subject	Σ	1..1	Reference(PatientCreate)	Element id Condition.subject Short description Who has the condition? Alternate names patient Definition Indicates the patient or group who the condition record is associated with. Requirements Group is typically used for veterinary or public health use cases. Data type Reference(PatientCreate) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.subject w5: FiveWs.subject[x] v2: PID-3 rim: .participation[typeCode=SBJ].role[classCode=PAT] w5: FiveWs.subject
encounter	Σ	0..0	Reference(Encounter)	There are no (further) constraints on this element Element id Condition.encounter Short description Encounter created as part of Definition The Encounter during which this Condition was created or to which the creation of this record is tightly associated. Comments This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. This record indicates the encounter this particular record is associated with. In the case of a "new" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first "known". Data type Reference(Encounter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.context w5: FiveWs.context v2: PV1-19 (+PV1-54) rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
onset[x]	Σ	0..0		There are no (further) constraints on this element Element id Condition.onset[x] Short description Estimated or actual date, date-time, or age Definition Estimated or actual date or date-time the condition began, in the opinion of the clinician. Comments Age is generally used when the patient reports an age at which the Condition began to occur. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.occurrence[x] w5: FiveWs.init v2: PRB-16 rim: .effectiveTime.low or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at onset"].value
abatement[x]	I	0..0		There are no (further) constraints on this element Element id Condition.abatement[x] Short description When in resolution/remission Definition The date or estimated date that the condition resolved or went into remission. This is called "abatement" because of the many overloaded connotations associated with "remission" or "resolution" - Conditions are never really resolved, but they can abate. Comments There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated. If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid. When abatementString exists, it implies the condition is abated. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.done[x] rim: .effectiveTime.high or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at remission"].value or .inboundRelationship[typeCode=SUBJ]source[classCode=CONC, moodCode=EVN].status=completed
recordedDate	Σ	0..0	dateTime	There are no (further) constraints on this element Element id Condition.recordedDate Short description Date record was first recorded Definition The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.recorded v2: REL-11 rim: .participation[typeCode=AUT].time
recorder	Σ	0..0	Reference(Practitioner \| PractitionerRole \| Patient \| RelatedPerson)	There are no (further) constraints on this element Element id Condition.recorder Short description Who recorded the condition Definition Individual who recorded the record and takes responsibility for its content. Data type Reference(Practitioner \| PractitionerRole \| Patient \| RelatedPerson) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.author rim: .participation[typeCode=AUT].role
asserter	Σ	0..0	Reference(Practitioner \| PractitionerRole \| Patient \| RelatedPerson)	There are no (further) constraints on this element Element id Condition.asserter Short description Person who asserts this condition Definition Individual who is making the condition statement. Data type Reference(Practitioner \| PractitionerRole \| Patient \| RelatedPerson) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.source v2: REL-7.1 identifier + REL-7.12 type code rim: .participation[typeCode=INF].role
stage	I	0..0	BackboneElement	There are no (further) constraints on this element Element id Condition.stage Short description Stage/grade, usually assessed formally Definition Clinical stage or grade of a condition. May include formal severity assessments. Data type BackboneElement Constraints con-1: Stage SHALL have summary or assessment `summary.exists() or assessment.exists()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="stage/grade"]
evidence	I	0..0	BackboneElement	There are no (further) constraints on this element Element id Condition.evidence Short description Supporting evidence Definition Supporting evidence / manifestations that are the basis of the Condition's verification status, such as evidence that confirmed or refuted the condition. Comments The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both. Data type BackboneElement Constraints con-2: evidence SHALL have code or details `code.exists() or detail.exists()` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=SPRT].target[classCode=OBS, moodCode=EVN]
note		0..0	Annotation	There are no (further) constraints on this element Element id Condition.note Short description Additional information about the Condition Definition Additional information about the Condition. This is a general notes/comments entry for description of the Condition, its diagnosis and prognosis. Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.note v2: NTE child of PRB rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value

Medication

MedicationCreate (Medication)	I		Medication	There are no (further) constraints on this element Element id Medication Short description Definition of a Medication Definition This resource is primarily used for the identification and definition of a medication for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use. Data type Medication Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act script10.6: NewRx/MedicationPrescribed -or- RxFill/MedicationDispensed -or- RxHistoryResponse/MedicationDispensed -or- RxHistoryResponse/MedicationPrescribed rim: ManufacturedProduct[classCode=ADMM]
id	Σ	0..1	string	There are no (further) constraints on this element Element id Medication.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Medication.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Medication.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Medication.language Short description Language of the resource content Definition The base language in which the resource is written. 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id Medication.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Medication.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. 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. Data type Resource Mappings rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Medication.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Medication.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier	Σ	0..0	Identifier	There are no (further) constraints on this element Element id Medication.identifier Short description Business identifier for this medication Definition Business identifier for this medication. Comments The serial number could be included as an identifier. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier rim: .id
code	Σ	0..1	CodeableConceptBinding	Element id Medication.code Short description Codes that identify this medication Definition A code (or set of codes) that specify this medication, or a textual description if no code is available. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systems. Comments Depending on the context of use, the code that was actually selected by the user (prescriber, dispenser, etc.) will have the coding.userSelected set to true. As described in the coding datatype: "A coding may be marked as a "userSelected" if a user selected the particular coded value in a user interface (e.g. the user selects an item in a pick-list). If a user selected coding exists, it is the preferred choice for performing translations etc. Other codes can only be literal translations to alternative code systems, or codes at a lower level of granularity (e.g. a generic code for a vendor-specific primary one). Data type CodeableConcept Binding A coded concept that defines the type of a medication. http://www.qualitype.de/samples/fhir/CodeSystem/medications (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings script10.6: coding.code = //element(,MedicationType)/DrugCoded/ProductCode coding.system = //element(,MedicationType)/DrugCoded/ProductCodeQualifier coding.display = //element(,MedicationType)/DrugDescription w5:* FiveWs.class v2: RXO-1.1-Requested Give Code.code / RXE-2.1-Give Code.code / RXD-2.1-Dispense/Give Code.code / RXG-4.1-Give Code.code /RXA-5.1-Administered Code.code / RXC-2.1 Component Code rim: .code
id		0..1	string	There are no (further) constraints on this element Element id Medication.code.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Medication.code.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
coding	Σ	0..1	Coding	There are no (further) constraints on this element Element id Medication.code.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
text	Σ	0..0	string	There are no (further) constraints on this element Element id Medication.code.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
status	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id Medication.status Short description active \| inactive \| entered-in-error Definition A code to indicate if the medication is in active use. Comments This status is intended to identify if the medication in a local system is in active use within a drug database or inventory. For example, a pharmacy system may create a new drug file record for a compounded product "ABC Hospital Special Cream" with an active status. At some point in the future, it may be determined that the drug record was created with an error and the status is changed to "entered in error". This status is not intended to specify if a medication is part of a particular formulary. It is possible that the drug record may be referenced by multiple formularies or catalogues and each of those entries would have a separate status. Data type code Binding A coded concept defining if the medication is in active use. Medication Status Codes (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .statusCode
manufacturer	Σ	0..0	Reference(Organization)	There are no (further) constraints on this element Element id Medication.manufacturer Short description Manufacturer of the item Definition Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication product. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings script10.6: no mapping w5: FiveWs.actor v2: RXD-20-Substance Manufacturer Name / RXG-21-Substance Manufacturer Name / RXA-17-Substance Manufacturer Name rim: .player.scopingRole[typeCode=MANU].scoper
form		0..0	CodeableConcept	There are no (further) constraints on this element Element id Medication.form Short description powder \| tablets \| capsule + Definition Describes the form of the item. Powder; tablets; capsule. Comments When Medication is referenced from MedicationRequest, this is the ordered form. When Medication is referenced within MedicationDispense, this is the dispensed form. When Medication is referenced within MedicationAdministration, this is administered form. Data type CodeableConcept Binding A coded concept defining the form of a medication. SNOMEDCTFormCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings script10.6: coding.code = //element(,DrugCodedType)/FormCode coding.system = //element(,DrugCodedType)/FormSourceCode v2: RXO-5-Requested Dosage Form / RXE-6-Give Dosage Form / RXD-6-Actual Dosage Form / RXG-8-Give Dosage Form / RXA-8-Administered Dosage Form rim: .formCode
amount	Σ	0..0	Ratio	There are no (further) constraints on this element Element id Medication.amount Short description Amount of drug in package Definition Specific amount of the drug in the packaged product. For example, when specifying a product that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification of the package amount (For example, 3 mL, 10mL, etc.). Data type Ratio Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .quantity
ingredient		0..0	BackboneElement	There are no (further) constraints on this element Element id Medication.ingredient Short description Active or inactive ingredient Definition Identifies a particular constituent of interest in the product. Comments The ingredients need not be a complete list. If an ingredient is not specified, this does not indicate whether an ingredient is present or absent. If an ingredient is specified it does not mean that all ingredients are specified. It is possible to specify both inactive and active ingredients. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .scopesRole[typeCode=INGR]
batch		0..0	BackboneElement	There are no (further) constraints on this element Element id Medication.batch Short description Details about packaged medications Definition Information that only applies to packages (not products). Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings script10.6: no mapping rim: .player[classCode=CONT]

Specimen

SpecimenCreate (Specimen)	I		Specimen	There are no (further) constraints on this element Element id Specimen Short description Sample for analysis Definition A sample to be used for analysis. Data type Specimen Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act rim: Role[classCode=SPEC]
id	Σ	0..1	string	There are no (further) constraints on this element Element id Specimen.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Specimen.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Specimen.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Specimen.language Short description Language of the resource content Definition The base language in which the resource is written. 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id Specimen.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Specimen.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. 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. Data type Resource Mappings rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Specimen.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Specimen.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Specimen.identifier Short description External Identifier Definition Id for specimen. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier v2: SPM-2 rim: .id
accessionIdentifier	Σ	0..0	Identifier	There are no (further) constraints on this element Element id Specimen.accessionIdentifier Short description Identifier assigned by the lab Definition The identifier assigned by the lab when accessioning specimen(s). This is not necessarily the same as the specimen identifier, depending on local lab procedures. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier v2: SPM-30 (v2.7+) rim: .participation[typeCode=SBJ].act[classCode=ACSN, moodCode=EVN].id
status	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id Specimen.status Short description available \| unavailable \| unsatisfactory \| entered-in-error Definition The availability of the specimen. Comments This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Data type code Binding Codes providing the status/availability of a specimen. SpecimenStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.status v2: SPM-20 rim: status
type	Σ	0..1	CodeableConceptBinding	Element id Specimen.type Short description Kind of material that forms the specimen Definition The kind of material that forms the specimen. Comments The type can change the way that a specimen is handled and drives what kind of analyses can properly be performed on the specimen. It is frequently used in diagnostic work flow decision making systems. Data type CodeableConcept Binding The type of the specimen. http://www.qualitype.de/samples/fhir/CodeSystem/sampletypes (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.what[x] v2: SPM-4 and possibly SPM-5 rim: .code
id		0..1	string	There are no (further) constraints on this element Element id Specimen.type.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Specimen.type.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
coding	Σ	0..1	Coding	There are no (further) constraints on this element Element id Specimen.type.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
text	Σ	0..0	string	There are no (further) constraints on this element Element id Specimen.type.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
subject	Σ	0..0	Reference(Patient \| Group \| Device \| Substance \| Location)	There are no (further) constraints on this element Element id Specimen.subject Short description Where the specimen came from. This may be from patient(s), from a location (e.g., the source of an environmental sample), or a sampling of a substance or a device Definition Where the specimen came from. This may be from patient(s), from a location (e.g., the source of an environmental sample), or a sampling of a substance or a device. Requirements Must know the subject context. Data type Reference(Patient \| Group \| Device \| Substance \| Location) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.subject[x] rim: .scoper or .scoper.playsRole w5: FiveWs.subject
receivedTime	Σ	0..0	dateTime	There are no (further) constraints on this element Element id Specimen.receivedTime Short description The time when specimen was received for processing Definition Time when specimen was received for processing or testing. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.done[x] v2: SPM-18 rim: .participation[typeCode=SBJ].act[code=SPCREC, moodCode=EVN].effectiveTime
parent		0..0	Reference(Specimen)	There are no (further) constraints on this element Element id Specimen.parent Short description Specimen from which this specimen originated Definition Reference to the parent (source) specimen which is used when the specimen was either derived from or a component of another specimen. Comments The parent specimen could be the source from which the current specimen is derived by some processing step (e.g. an aliquot or isolate or extracted nucleic acids from clinical samples) or one of many specimens that were combined to create a pooled sample. Data type Reference(Specimen) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .scoper (if parent) .player.scopesRole[classCode=SPEC].player (if child)
request		0..0	Reference(ServiceRequest)	There are no (further) constraints on this element Element id Specimen.request Short description Why the specimen was collected Definition Details concerning a service request that required a specimen to be collected. Comments The request may be explicit or implied such with a ServiceRequest that requires a blood draw. Data type Reference(ServiceRequest) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.why[x] v2: ORC? OBR-2/3? rim: outboundRelationship[typeCode=FLFS].target
collection		0..1	BackboneElement	There are no (further) constraints on this element Element id Specimen.collection Short description Collection details Definition Details concerning the specimen collection. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SPM-14 rim: .participation[typeCode=SBJ].act[classCode=SPECCOLLECT, moodCode=EVN]
id		0..1	string	There are no (further) constraints on this element Element id Specimen.collection.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Specimen.collection.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Specimen.collection.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
collector	Σ	0..0	Reference(Practitioner \| PractitionerRole)	There are no (further) constraints on this element Element id Specimen.collection.collector Short description Who collected the specimen Definition Person who collected the specimen. Data type Reference(Practitioner \| PractitionerRole) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.actor v2: PRT rim: .participation[typeCode=PFM].role
collected[x]	Σ	0..1		There are no (further) constraints on this element Element id Specimen.collection.collected[x] Short description Collection time Definition Time when specimen was collected from subject - the physiologically relevant time. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.init v2: SPM-17 rim: .effectiveTime
collectedDateTime			dateTime	Data type dateTime
duration	Σ	0..0	Duration	There are no (further) constraints on this element Element id Specimen.collection.duration Short description How long it took to collect specimen Definition The span of time over which the collection of a specimen occurred. Data type Duration Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.init
quantity		0..0	SimpleQuantity	There are no (further) constraints on this element Element id Specimen.collection.quantity Short description The quantity of specimen collected Definition The quantity of specimen collected; for instance the volume of a blood sample, or the physical measurement of an anatomic pathology sample. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SPM-12 rim: .participation[typeCode=SBJ].role[classCode=SPEC].player.quantity
method		0..0	CodeableConcept	There are no (further) constraints on this element Element id Specimen.collection.method Short description Technique used to perform collection Definition A coded value specifying the technique that is used to perform the procedure. Data type CodeableConcept Binding The technique that is used to perform the procedure. FHIRSpecimenCollectionMethod (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SPM-7 rim: .methodCode
bodySite		0..0	CodeableConcept	There are no (further) constraints on this element Element id Specimen.collection.bodySite Short description Anatomical collection site Definition Anatomical location from which the specimen was collected (if subject is a patient). This is the target site. This element is not used for environmental specimens. Comments If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension bodySite. Data type CodeableConcept Binding Codes describing anatomical locations. May include laterality. SNOMEDCTBodyStructures (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SPM-8 and SPM-9 rim: .targetSiteCode
fastingStatus[x]	Σ	0..0	Binding	There are no (further) constraints on this element Element id Specimen.collection.fastingStatus[x] Short description Whether or how long patient abstained from food and/or drink Definition Abstinence or reduction from some or all food, drink, or both, for a period of time prior to sample collection. Requirements Many diagnostic tests require fasting to facilitate accurate interpretation. Comments Representing fasting status using this element is preferred to representing it with an observation using a 'pre-coordinated code' such as LOINC 2005-7 (Calcium [Moles/time] in 2 hour Urine --12 hours fasting), or using a component observation `such as`Observation.component code` = LOINC 49541-6 (Fasting status - Reported). Binding Codes describing the fasting status of the patient. v2.0916 (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBR-
processing		0..0	BackboneElement	There are no (further) constraints on this element Element id Specimen.processing Short description Processing and processing step details Definition Details concerning processing and processing steps for the specimen. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .participation[typeCode=SBJ].act[code=SPCTRT, moodCode=EVN]
container		0..*	BackboneElement	There are no (further) constraints on this element Element id Specimen.container Short description Direct container of specimen (tube/slide, etc.) Definition The container holding the specimen. The recursive nature of containers; i.e. blood in tube in tray in rack is not addressed here. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .player.scopingRole[classCode=CONT].scoper
id		0..1	string	There are no (further) constraints on this element Element id Specimen.container.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Specimen.container.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Specimen.container.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier	Σ	0..0	Identifier	There are no (further) constraints on this element Element id Specimen.container.identifier Short description Id for the container Definition Id for container. There may be multiple; a manufacturer's bar code, lab assigned identifier, etc. The container ID may differ from the specimen id in some circumstances. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SAC-3 rim: .id
description		0..0	string	There are no (further) constraints on this element Element id Specimen.container.description Short description Textual description of the container Definition Textual description of the container. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .desc
type		0..0	CodeableConcept	There are no (further) constraints on this element Element id Specimen.container.type Short description Kind of container directly associated with specimen Definition The type of container associated with the specimen (e.g. slide, aliquot, etc.). Data type CodeableConcept Binding Type of specimen container. SpecimenContainerType (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SPM-27 rim: .code
capacity		0..0	SimpleQuantity	There are no (further) constraints on this element Element id Specimen.container.capacity Short description Container volume or size Definition The capacity (volume or other measure) the container may contain. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: one of: SAC 16, SAC17 and SAC 20, or SAC 21 and SAC 20 rim: .quantity
specimenQuantity		0..1	SimpleQuantityBinding	Element id Specimen.container.specimenQuantity Short description Quantity of specimen within container Definition The quantity of specimen in the container; may be volume, dimensions, or other appropriate measurements, depending on the specimen type. Data type SimpleQuantity Binding http://www.qualitype.de/samples/fhir/CodeSystem/units (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SAC-23 (value) SAC-24 (units rim: .playedRole[classCode=CONT].quantity
additive[x]		0..0		There are no (further) constraints on this element Element id Specimen.container.additive[x] Short description Additive associated with container Definition Introduced substance to preserve, maintain or enhance the specimen. Examples: Formalin, Citrate, EDTA. Binding Substance added to specimen container. v2.0371 (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SAC-27 rim: .scopesRole[classCode=ADTV].player
condition	Σ	0..0	CodeableConceptBinding	There are no (further) constraints on this element Element id Specimen.condition Short description State of the specimen Definition A mode or state of being that describes the nature of the specimen. Requirements The specimen condition can be used to assess its quality or appropriateness for a specific test. Comments Specimen condition is an observation made about the specimen. It's a point-in-time assessment. It can be used to assess its quality or appropriateness for a specific test. Data type CodeableConcept Binding Codes describing the state of the specimen. v2.0493 (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SPM-24
note		0..0	Annotation	There are no (further) constraints on this element Element id Specimen.note Short description Comments Definition To communicate any details or issues about the specimen or during the specimen collection. (for example: broken vial, sent with patient, frozen). Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value

NotificationUrl extension

NotificationUrl (Extension)	I		Extension	Element id Extension Short description Optional Extensions Element Definition An URL to get notifications. At each workflow step, the current 'DiagnosticReport' resource is sent to this URL. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
id		0..1	string	There are no (further) constraints on this element Element id Extension.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Extension.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
url		1..1	uriFixed Value	Element id Extension.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value http://www.qualitype.de/samples/fhir/StructureDefinition/notification-url Mappings rim: N/A
value[x]		0..1		There are no (further) constraints on this element Element id Extension.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueUrl			url	Data type url

Example

{
    "resourceType": "ServiceRequest",
    "id": "servicerequest-example-create",
    "contained":  [
        {
            "resourceType": "Patient",
            "id": "patient-example-create",
            "identifier":  [
                {
                    "system": "http://www.acme.com/fhir/NamingSystem/patient-identifier",
                    "value": "patient-extern-123"
                }
            ]
        },
        {
            "resourceType": "Condition",
            "id": "condition-example-create",
            "code": {
                "coding":  [
                    {
                        "code": "DIAGNOSIS-1",
                        "system": "http://www.qualitype.de/samples/fhir/CodeSystem/diagnoses"
                    }
                ]
            },
            "subject": {
                "reference": "#patient-example-create"
            }
        },
        {
            "resourceType": "Medication",
            "id": "medication-example-create",
            "code": {
                "coding":  [
                    {
                        "code": "MEDIKATION-1",
                        "system": "http://www.qualitype.de/samples/fhir/CodeSystem/medications"
                    }
                ]
            }
        },
        {
            "resourceType": "Specimen",
            "id": "specimen-example-create",
            "identifier":  [
                {
                    "system": "http://www.acme.com/fhir/NamingSystem/specimen-identifier",
                    "value": "sample-extern-123"
                }
            ],
            "type": {
                "coding":  [
                    {
                        "code": "SAMPLETYPE-1",
                        "system": "http://www.qualitype.de/samples/fhir/CodeSystem/sampletypes"
                    }
                ]
            },
            "collection": {
                "collectedDateTime": "07/01/2023 12:00:00"
            },
            "container":  [
                {
                    "specimenQuantity": {
                        "value": 10,
                        "code": "mL",
                        "system": "http://www.qualitype.de/samples/fhir/CodeSystem/units"
                    }
                }
            ]
        }
    ],
    "extension":  [
        {
            "url": "http://www.qualitype.de/samples/fhir/StructureDefinition/notification-url",
            "valueUrl": "http://www.acme.com/notifyme"
        }
    ],
    "identifier":  [
        {
            "system": "http://www.acme.com/fhir/NamingSystem/servicerequest-identifier",
            "value": "order-extern-123"
        }
    ],
    "status": "active",
    "intent": "order",
    "code": {
        "coding":  [
            {
                "code": "GOAL-1",
                "system": "http://www.qualitype.de/samples/fhir/CodeSystem/goals"
            }
        ]
    },
    "subject": {
        "reference": "#patient-example-create"
    },
    "requester": {
        "reference": "Organization/acme"
    },
    "reasonCode":  [
        {
            "coding":  [
                {
                    "code": "INDICATION-1",
                    "system": "http://www.qualitype.de/samples/fhir/CodeSystem/indications"
                }
            ]
        }
    ],
    "supportingInfo":  [
        {
            "reference": "#condition-example-create"
        },
        {
            "reference": "#medication-example-create"
        }
    ],
    "specimen":  [
        {
            "reference": "#specimen-example-create"
        }
    ]
}