GP Connect Data Model | FHIR STU3 Representation

This version is in draft and is currently being migrated from the GP Connect Access Record: Structured specification

Profile: CareConnect-GPC-AllergyIntolerance-1

idΣ0..1id
id0..1string
extensionI0..*Extension
versionIdΣ0..1id
lastUpdatedΣ0..1instant
profileΣ1..*uri
securityΣ0..*CodingBinding
tagΣ0..*Coding
implicitRulesΣ ?!0..1uri
language0..1codeBinding
textI0..1Narrative
contained0..*Resource
encounterS I0..1Extension(Reference(Encounter))
allergyEndS I0..1Extension(Complex)
evidenceI0..1Extension(Reference(DiagnosticReport))
modifierExtension?! I0..*Extension
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ1..1uri
valueΣ1..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
clinicalStatusΣ ?! I1..1codeBinding
verificationStatusΣ ?! I1..1codeBindingFixed Value
typeΣ0..1codeBinding
categoryΣ1..*codeBinding
criticalityΣ0..1codeBinding
id0..1string
extensionI0..*Extension
id0..1string
snomedCTDescriptionIDI0..1Extension(Complex)
systemΣ1..1uri
versionΣ0..0string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
patientΣ I1..1Reference(CareConnect-GPC-Patient-1)
onsetDateTimedateTime
onsetAgeAge
onsetPeriodPeriod
onsetRangeRange
onsetStringstring
assertedDate1..1dateTime
recorderI1..1Reference(CareConnect-GPC-Patient-1 | CareConnect-GPC-Practitioner-1)
asserterS Σ I0..1Reference(RelatedPerson | CareConnect-GPC-Patient-1 | CareConnect-GPC-Practitioner-1)
lastOccurrence0..1dateTime
id0..1string
extensionI0..*Extension
authorStringstring
authorReferenceReference(RelatedPerson | CareConnect-GPC-Patient-1 | CareConnect-GPC-Practitioner-1)
timeΣ0..1dateTime
text1..1string
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
id0..1string
extensionI0..*Extension
id0..1string
snomedCTDescriptionIDI0..1Extension(Complex)
systemΣ1..1uriFixed Value
versionΣ0..0string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
id0..1string
extensionI0..*Extension
id0..1string
snomedCTDescriptionIDI0..1Extension(Complex)
systemΣ1..1uriFixed Value
versionΣ0..0string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
description0..1string
onset0..1dateTime
severityS0..1codeBinding
id0..1string
extensionI0..*Extension
id0..1string
snomedCTDescriptionIDI0..1Extension(Complex)
systemΣ1..1uriFixed Value
versionΣ0..0string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
id0..1string
extensionI0..*Extension
authorStringstring
authorReferenceReference(RelatedPerson | CareConnect-GPC-Patient-1 | CareConnect-GPC-Practitioner-1)
timeΣ0..1dateTime
text1..1string
AllergyIntolerance
DefinitionRisk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance.
Cardinality0...*
AliasAllergy, Intolerance, Adverse Reaction
Comments

Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.

Invariants
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative
    contained.text.empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
    contained.where(('#'+id in %resource.descendants().reference).not()).empty()
  • ait-1: AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
    verificationStatus='entered-in-error' or clinicalStatus.exists()
  • ait-2: AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
    verificationStatus!='entered-in-error' or clinicalStatus.empty()
Mappings
  • rim: Entity. Role, or Act
  • rim: Observation[classCode=OBS, moodCode=EVN]
  • w5: clinical.general
AllergyIntolerance.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typeid
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.meta
DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
Cardinality0...1
TypeMeta
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.meta.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.meta.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (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
AllergyIntolerance.meta.versionId
DefinitionThe version specific identifier, as it appears in the version portion of the URL. This values changes when the resource is created, updated, or deleted.
Cardinality0...1
Typeid
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.meta.lastUpdated
DefinitionWhen the resource last changed - e.g. when the version changed.
Cardinality0...1
Typeinstant
SummaryTrue
Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.meta.profile
DefinitionA list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url]().
Cardinality1...*
Typeuri
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.meta.security
DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
Cardinality0...*
TypeCoding
Binding
Security Labels from the Healthcare Privacy and Security Classification System.
All Security Labels (extensible)
SummaryTrue
Comments

The security labels can be updated without changing the stated version of the resource The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
AllergyIntolerance.meta.tag
DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
Cardinality0...*
TypeCoding
Binding
Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
Common Tags (example)
SummaryTrue
Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
AllergyIntolerance.implicitRules
DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
Cardinality0...1
Typeuri
ModifierTrue
SummaryTrue
Comments

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

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

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

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.text
DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality0...1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
  • rim: Act.text?
AllergyIntolerance.contained
DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality0...*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

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

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
AllergyIntolerance.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. In order 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (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
AllergyIntolerance.extension:encounter
DefinitionAn associated encounter reference.
Cardinality0...1
TypeExtension(Reference(Encounter))
Must SupportTrue
Aliasextensions, user content
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.extension:allergyEnd
DefinitionSupports the date and reason that the allergy was no longer valid.
Cardinality0...1
TypeExtension(Complex)
Must SupportTrue
Aliasextensions, user content
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.extension:evidence
DefinitionA reference to results of investigations that confirmed the certainty of the diagnosis.
Cardinality0...1
TypeExtension(Reference(DiagnosticReport))
Aliasextensions, user content
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (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
AllergyIntolerance.identifier
DefinitionThis records identifiers associated with this allergy/intolerance concern that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).
Cardinality1...*
TypeIdentifier
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • v2: IAM-7
  • rim: id
  • w5: id
AllergyIntolerance.identifier.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.identifier.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (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
AllergyIntolerance.identifier.use
DefinitionThe purpose of this identifier.
Cardinality0...1
Typecode
Binding
Identifies the purpose for this identifier, if known .
IdentifierUse (required)
ModifierTrue
SummaryTrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Role.code or implied by context
AllergyIntolerance.identifier.type
DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Cardinality0...1
TypeCodeableConcept
Binding
A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Identifier Type Codes (extensible)
SummaryTrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.

Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
AllergyIntolerance.identifier.system
DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique.
Cardinality1...1
Typeuri
SummaryTrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

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

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

http://www.acme.com/identifiers/patient


Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
AllergyIntolerance.identifier.value
DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system.
Cardinality1...1
Typestring
SummaryTrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.

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

123456


Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
AllergyIntolerance.identifier.period
DefinitionTime period during which identifier is/was valid for use.
Cardinality0...1
TypePeriod
SummaryTrue
Comments

This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
AllergyIntolerance.identifier.assigner
DefinitionOrganization that issued/manages the identifier.
Cardinality0...1
TypeReference(Organization)
SummaryTrue
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
AllergyIntolerance.clinicalStatus
DefinitionThe clinical status of the allergy or intolerance.
Cardinality1...1
Typecode
Binding
The clinical status of the allergy or intolerance.
AllergyIntoleranceClinicalStatus (required)
ModifierTrue
SummaryTrue
Comments

This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as not currently valid.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="clinicalStatus", moodCode=EVN].value
  • w5: status
AllergyIntolerance.verificationStatus
DefinitionAssertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product).
Cardinality1...1
Typecode
Binding
Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.
AllergyIntoleranceVerificationStatus (required)
ModifierTrue
SummaryTrue
Comments

This element is labeled as a modifier because the status contains the codes refuted and entered-in-error that mark the AllergyIntolerance as not currently valid.

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

unconfirmed

Mappings
  • rim: n/a
  • rim: Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="verificationStatus", moodCode=EVN].value
  • w5: status
AllergyIntolerance.type
DefinitionIdentification of the underlying physiological mechanism for the reaction risk.
Cardinality0...1
Typecode
Binding
Identification of the underlying physiological mechanism for a Reaction Risk.
AllergyIntoleranceType (required)
SummaryTrue
AliasCategory, Class
Comments

Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term "allergy" is used rather generically and may overlap with the use of "intolerance" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: IAM-9
  • rim: code
  • w5: class
AllergyIntolerance.category
DefinitionCategory of the identified substance.
Cardinality1...*
Typecode
Binding
Category of an identified substance.
AllergyIntoleranceCategory (required)
SummaryTrue
AliasCategory, Type, Reaction Type, Class
Comments

This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation. When searching on category, consider the implications of AllergyIntolerance resources without a category. For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned. Refer to search for more information on how to search category with a :missing modifier to get allergies that don't have a category. Additionally, category should be used with caution because category can be subjective based on the sender.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: AL1-2
  • rim: value < IntoleranceValue (Agent)
  • w5: class
AllergyIntolerance.criticality
DefinitionEstimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.
Cardinality0...1
Typecode
Binding
Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.
AllergyIntoleranceCriticality (required)
SummaryTrue
AliasSeverity, Seriousness, Contra-indication, Risk
Comments

The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).

Systems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity. Existing systems that are capturing both condition criticality and reaction severity may use the term "severity" to represent both. Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: AL1-4
  • rim: inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)]
  • w5: grade
AllergyIntolerance.code
DefinitionCode for an allergy or intolerance statement (either a positive or a negated/excluded statement). This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., "Latex"), an allergy or intolerance condition (e.g., "Latex allergy"), or a negated/excluded code for a specific substance or class (e.g., "No latex allergy") or a general or categorical negated statement (e.g., "No known allergy", "No known drug allergies").
Cardinality1...1
TypeCodeableConcept
Binding
Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies.
Care Connect Allergy Code (example)
SummaryTrue
AliasCode
Comments

It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.

When a substance or product code is specified for the 'code' element, the "default" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product. In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the "Causative agent" relationship.

The 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements. This extension provides the capability to make "no known allergy" (or "no risk of adverse reaction") statements regarding any coded substance/product (including cases when a pre-coordinated "no allergy to x" concept for that substance/product does not exist). If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: AL1-3 / IAM-3
  • rim: substance/product: .participation[typeCode=CAGNT].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType] negated/excluded substance/product: .participation[typeCode=CAGNT, negationInd=true].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType] positive or negated/excluded condition/situation: Observation.code=ASSERTION; Observation.value
  • w5: what
AllergyIntolerance.code.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.code.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (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
AllergyIntolerance.code.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
AllergyIntolerance.code.coding.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.code.coding.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (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
AllergyIntolerance.code.coding.extension:snomedCTDescriptionID
DefinitionThe SNOMED CT Description ID for the display.
Cardinality0...1
TypeExtension(Complex)
Aliasextensions, user content
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.code.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality1...1
Typeuri
SummaryTrue
Requirements

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

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
AllergyIntolerance.code.coding.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...0
Typestring
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
AllergyIntolerance.code.coding.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
AllergyIntolerance.code.coding.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

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

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
AllergyIntolerance.code.coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
AllergyIntolerance.code.text
DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality0...1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
AllergyIntolerance.patient
DefinitionThe patient who has the allergy or intolerance.
Cardinality1...1
TypeReference(CareConnect-GPC-Patient-1)
SummaryTrue
AliasPatient
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: (PID-3)
  • rim: .participation[typeCode=SBJ].role[classCode=PAT]
  • w5: who.focus
AllergyIntolerance.onset[x]
DefinitionEstimated or actual date, date-time, or age when allergy or intolerance was identified.
Cardinality0...1
TypedateTime, Age, Period, Range, string
Must SupportTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: effectiveTime.low
  • w5: when.init
AllergyIntolerance.assertedDate
DefinitionThe date on which the existance of the AllergyIntolerance was first asserted or acknowledged.
Cardinality1...1
TypedateTime
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: IAM-20
  • rim: .participation[typeCode=AUT].time
  • w5: when.recorded
AllergyIntolerance.recorder
DefinitionIndividual who recorded the record and takes responsibility for its content.
Cardinality1...1
TypeReference(CareConnect-GPC-Patient-1 | CareConnect-GPC-Practitioner-1)
AliasAuthor
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim: .participation[typeCode=AUT].role
  • w5: who.author
AllergyIntolerance.asserter
DefinitionThe source of the information about the allergy that is recorded.
Cardinality0...1
TypeReference(RelatedPerson | CareConnect-GPC-Patient-1 | CareConnect-GPC-Practitioner-1)
Must SupportTrue
SummaryTrue
AliasSource, Informant
Comments

The recorder takes repsonsibility for the content, but can reference the source from where they got it.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: IAM-14 (if patient) / IAM-18 (if practitioner)
  • rim: .participation[typeCode=INF].role
  • w5: who.source
AllergyIntolerance.lastOccurrence
DefinitionRepresents the date and/or time of the last known occurrence of a reaction event.
Cardinality0...1
TypedateTime
Comments

This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)].effectiveTime
AllergyIntolerance.note
DefinitionAdditional narrative about the propensity for the Adverse Reaction, not captured in other fields.
Cardinality0...*
TypeAnnotation
Must SupportTrue
Comments

For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and AllergyIntolerance.event.notes.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act
  • rim: subjectOf.observationEvent[code="annotation"].value
AllergyIntolerance.note.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.note.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (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
AllergyIntolerance.note.author[x]
DefinitionThe individual responsible for making the annotation.
Cardinality0...1
TypeReference(RelatedPerson | CareConnect-GPC-Patient-1 | CareConnect-GPC-Practitioner-1), string
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.participant[typeCode=AUT].role
AllergyIntolerance.note.time
DefinitionIndicates when this particular annotation was made.
Cardinality0...1
TypedateTime
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.effectiveTime
AllergyIntolerance.note.text
DefinitionThe text of the annotation.
Cardinality1...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.text
AllergyIntolerance.reaction
DefinitionDetails about each adverse reaction event linked to exposure to the identified substance.
Cardinality0...*
TypeBackboneElement
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)]
AllergyIntolerance.reaction.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.reaction.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (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
AllergyIntolerance.reaction.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (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
AllergyIntolerance.reaction.substance
DefinitionIdentification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'.
Cardinality0...1
TypeCodeableConcept
Binding
Codes defining the type of the substance (including pharmaceutical products).
Substance Code (example)
Comments

Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible. The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, "penicillins"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, "amoxycillin"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim: outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].participation[typeCode=CSM].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType]
AllergyIntolerance.reaction.substance.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.reaction.substance.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (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
AllergyIntolerance.reaction.substance.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
Requirements

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

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.

SlicingUnordered, Open, by system(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
AllergyIntolerance.reaction.substance.coding:snomedCT
DefinitionA reference to a code defined by a terminology system.
Cardinality0...1
TypeCoding
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
AllergyIntolerance.reaction.substance.coding:snomedCT.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.reaction.substance.coding:snomedCT.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (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
AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID
DefinitionThe SNOMED CT Description ID for the display.
Cardinality0...1
TypeExtension(Complex)
Aliasextensions, user content
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.substance.coding:snomedCT.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality1...1
Typeuri
SummaryTrue
Requirements

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

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

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

http://snomed.info/sct

Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
AllergyIntolerance.reaction.substance.coding:snomedCT.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...0
Typestring
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
AllergyIntolerance.reaction.substance.coding:snomedCT.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
AllergyIntolerance.reaction.substance.coding:snomedCT.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

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

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
AllergyIntolerance.reaction.substance.coding:snomedCT.userSelected
DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
AllergyIntolerance.reaction.substance.text
DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality0...1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
AllergyIntolerance.reaction.manifestation
DefinitionClinical symptoms and/or signs that are observed or associated with the adverse reaction event.
Cardinality1...*
TypeCodeableConcept
Binding
Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.
Care Connect Allergy Manifestation (extensible)
AliasSymptoms, Signs
Comments

Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines. Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: AL1-5
  • rim: code
AllergyIntolerance.reaction.manifestation.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.reaction.manifestation.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (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
AllergyIntolerance.reaction.manifestation.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
Requirements

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

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.

SlicingUnordered, Open, by system(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
AllergyIntolerance.reaction.manifestation.coding:snomedCT
DefinitionA reference to a code defined by a terminology system.
Cardinality0...1
TypeCoding
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
AllergyIntolerance.reaction.manifestation.coding:snomedCT.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (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
AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID
DefinitionThe SNOMED CT Description ID for the display.
Cardinality0...1
TypeExtension(Complex)
Aliasextensions, user content
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.manifestation.coding:snomedCT.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality1...1
Typeuri
SummaryTrue
Requirements

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

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

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

http://snomed.info/sct

Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
AllergyIntolerance.reaction.manifestation.coding:snomedCT.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...0
Typestring
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
AllergyIntolerance.reaction.manifestation.coding:snomedCT.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
AllergyIntolerance.reaction.manifestation.coding:snomedCT.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

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

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
AllergyIntolerance.reaction.manifestation.coding:snomedCT.userSelected
DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
AllergyIntolerance.reaction.manifestation.text
DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality0...1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
AllergyIntolerance.reaction.description
DefinitionText description about the reaction as a whole, including details of the manifestation if required.
Cardinality0...1
Typestring
AliasNarrative, Text
Comments

Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: text
AllergyIntolerance.reaction.onset
DefinitionRecord of the date and/or time of the onset of the Reaction.
Cardinality0...1
TypedateTime
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: AL1-6
  • rim: effectiveTime.low
AllergyIntolerance.reaction.severity
DefinitionClinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations.
Cardinality0...1
Typecode
Binding
Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.
AllergyIntoleranceSeverity (required)
Must SupportTrue
Comments

It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)]
AllergyIntolerance.reaction.exposureRoute
DefinitionIdentification of the route by which the subject was exposed to the substance.
Cardinality0...1
TypeCodeableConcept
Binding
A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
Care Connect Allergy Exposure Route (example)
Comments

Coding of the route of exposure with a terminology should be used wherever possible.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim: outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].routeCode
AllergyIntolerance.reaction.exposureRoute.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.reaction.exposureRoute.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (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
AllergyIntolerance.reaction.exposureRoute.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
Requirements

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

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.

SlicingUnordered, Open, by system(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT
DefinitionA reference to a code defined by a terminology system.
Cardinality0...1
TypeCoding
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (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
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID
DefinitionThe SNOMED CT Description ID for the display.
Cardinality0...1
TypeExtension(Complex)
Aliasextensions, user content
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality1...1
Typeuri
SummaryTrue
Requirements

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

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

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

http://snomed.info/sct

Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...0
Typestring
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

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

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.userSelected
DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
AllergyIntolerance.reaction.exposureRoute.text
DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality0...1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
AllergyIntolerance.reaction.note
DefinitionAdditional text about the adverse reaction event not captured in other fields.
Cardinality0...*
TypeAnnotation
Comments

Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act
  • rim: subjectOf.observationEvent[code="annotation"].value
AllergyIntolerance.reaction.note.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.reaction.note.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (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
AllergyIntolerance.reaction.note.author[x]
DefinitionThe individual responsible for making the annotation.
Cardinality0...1
TypeReference(RelatedPerson | CareConnect-GPC-Patient-1 | CareConnect-GPC-Practitioner-1), string
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.participant[typeCode=AUT].role
AllergyIntolerance.reaction.note.time
DefinitionIndicates when this particular annotation was made.
Cardinality0...1
TypedateTime
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.effectiveTime
AllergyIntolerance.reaction.note.text
DefinitionThe text of the annotation.
Cardinality1...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.text
<StructureDefinition xmlns="http://hl7.org/fhir">
    <meta>
        <lastUpdated value="2018-08-02T12:07:36.924+01:00" />
    </meta>
    <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
        <valueCode value="pc" />
    </extension>
    <url value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-AllergyIntolerance-1" />
    <version value="1.7.0" />
    <name value="CareConnect-GPC-AllergyIntolerance-1" />
    <status value="active" />
    <date value="2020-02-17" />
    <publisher value="HL7 UK" />
    <description value="This AllergyIntolerance Resource records Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance." />
    <copyright value="Copyright &#169; 2020 HL7 UK\n\nLicensed under the Apache License, Version 2.0 (the &quot;License&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at\n\nhttp://www.apache.org/licenses/LICENSE-2.0\n\nUnless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License.\n\nHL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7\n\nThe HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at\n\nhttps://www.hl7.org/fhir/license.html" />
    <fhirVersion value="3.0.1" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="AllergyIntolerance" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/AllergyIntolerance" />
    <derivation value="constraint" />
    <snapshot>
        <element id="AllergyIntolerance">
            <path value="AllergyIntolerance" />
            <short value="Allergy or Intolerance (generally: Risk of adverse reaction to a substance)" />
            <definition value="Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance." />
            <comment value="Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings." />
            <alias value="Allergy" />
            <alias value="Intolerance" />
            <alias value="Adverse Reaction" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Resource" />
                <min value="0" />
                <max value="*" />
            </base>
            <constraint>
                <key value="dom-2" />
                <severity value="error" />
                <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
                <expression value="contained.contained.empty()" />
                <xpath value="not(parent::f:contained and f:contained)" />
            </constraint>
            <constraint>
                <key value="dom-1" />
                <severity value="error" />
                <human value="If the resource is contained in another resource, it SHALL NOT contain any narrative" />
                <expression value="contained.text.empty()" />
                <xpath value="not(parent::f:contained and f:text)" />
            </constraint>
            <constraint>
                <key value="dom-4" />
                <severity value="error" />
                <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
                <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
                <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
            </constraint>
            <constraint>
                <key value="dom-3" />
                <severity value="error" />
                <human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource" />
                <expression value="contained.where((&#39;#&#39;+id in %resource.descendants().reference).not()).empty()" />
                <xpath value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $id))]))" />
            </constraint>
            <constraint>
                <key value="ait-1" />
                <severity value="error" />
                <human value="AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error." />
                <expression value="verificationStatus=&#39;entered-in-error&#39; or clinicalStatus.exists()" />
                <xpath value="f:verificationStatus/@value=&#39;entered-in-error&#39; or exists(f:clinicalStatus)" />
            </constraint>
            <constraint>
                <key value="ait-2" />
                <severity value="error" />
                <human value="AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error" />
                <expression value="verificationStatus!=&#39;entered-in-error&#39; or clinicalStatus.empty()" />
                <xpath value="f:verificationStatus/@value!=&#39;entered-in-error&#39; or not(exists(f:clinicalStatus))" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="Entity. Role, or Act" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Observation[classCode=OBS, moodCode=EVN]" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="clinical.general" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.id">
            <path value="AllergyIntolerance.id" />
            <short value="Logical id of this artifact" />
            <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
            <comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Resource.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="id" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.meta">
            <path value="AllergyIntolerance.meta" />
            <short value="Metadata about the resource" />
            <definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Resource.meta" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Meta" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.meta.id">
            <path value="AllergyIntolerance.meta.id" />
            <representation value="xmlAttr" />
            <short value="xml:id (or equivalent in JSON)" />
            <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.meta.extension">
            <path value="AllergyIntolerance.meta.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional Content defined by implementations" />
            <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.meta.versionId">
            <path value="AllergyIntolerance.meta.versionId" />
            <short value="Version specific identifier" />
            <definition value="The version specific identifier, as it appears in the version portion of the URL. This values changes when the resource is created, updated, or deleted." />
            <comment value="The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Meta.versionId" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="id" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.meta.lastUpdated">
            <path value="AllergyIntolerance.meta.lastUpdated" />
            <short value="When the resource version last changed" />
            <definition value="When the resource last changed - e.g. when the version changed." />
            <comment value="This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Meta.lastUpdated" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="instant" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.meta.profile">
            <path value="AllergyIntolerance.meta.profile" />
            <short value="Profiles this resource claims to conform to" />
            <definition value="A list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url]()." />
            <comment value="It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time.  The list of profile URLs is a set." />
            <min value="1" />
            <max value="*" />
            <base>
                <path value="Meta.profile" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.meta.security">
            <path value="AllergyIntolerance.meta.security" />
            <short value="Security Labels applied to this resource" />
            <definition value="Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure." />
            <comment value="The security labels can be updated without changing the stated version of the resource  The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Meta.security" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Coding" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="SecurityLabels" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
                    <valueBoolean value="true" />
                </extension>
                <strength value="extensible" />
                <description value="Security Labels from the Healthcare Privacy and Security Classification System." />
                <valueSetReference>
                    <reference value="http://hl7.org/fhir/ValueSet/security-labels" />
                </valueSetReference>
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.meta.tag">
            <path value="AllergyIntolerance.meta.tag" />
            <short value="Tags applied to this resource" />
            <definition value="Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource." />
            <comment value="The tags can be updated without changing the stated version of the resource.  The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Meta.tag" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Coding" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="Tags" />
                </extension>
                <strength value="example" />
                <description value="Codes that represent various types of tags, commonly workflow-related; e.g. &quot;Needs review by Dr. Jones&quot;" />
                <valueSetReference>
                    <reference value="http://hl7.org/fhir/ValueSet/common-tags" />
                </valueSetReference>
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.implicitRules">
            <path value="AllergyIntolerance.implicitRules" />
            <short value="A set of rules under which this content was created" />
            <definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content." />
            <comment value="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. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it&#39;s meaning or interpretation." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Resource.implicitRules" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isModifier value="true" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.language">
            <path value="AllergyIntolerance.language" />
            <short value="Language of the resource content" />
            <definition value="The base language in which the resource is written." />
            <comment value="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)." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Resource.language" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
                    <valueReference>
                        <reference value="http://hl7.org/fhir/ValueSet/all-languages" />
                    </valueReference>
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="Language" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
                    <valueBoolean value="true" />
                </extension>
                <strength value="extensible" />
                <description value="A human language." />
                <valueSetReference>
                    <reference value="http://hl7.org/fhir/ValueSet/languages" />
                </valueSetReference>
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.text">
            <path value="AllergyIntolerance.text" />
            <short value="Text summary of the resource, for human interpretation" />
            <definition value="A human-readable narrative that contains a summary of the resource, and may 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 &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
            <comment value="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 &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded in formation is added later." />
            <alias value="narrative" />
            <alias value="html" />
            <alias value="xhtml" />
            <alias value="display" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="DomainResource.text" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Narrative" />
            </type>
            <condition value="ele-1" />
            <condition value="dom-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Act.text?" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.contained">
            <path value="AllergyIntolerance.contained" />
            <short value="Contained, inline Resources" />
            <definition value="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." />
            <comment value="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." />
            <alias value="inline resources" />
            <alias value="anonymous resources" />
            <alias value="contained resources" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="DomainResource.contained" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Resource" />
            </type>
            <mapping>
                <identity value="rim" />
                <map value="Entity. Role, or Act" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.extension">
            <path value="AllergyIntolerance.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional Content defined by implementations" />
            <definition value="May be used to represent additional information that is not part of the basic definition of the resource. In order 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="DomainResource.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.extension:encounter">
            <path value="AllergyIntolerance.extension" />
            <sliceName value="encounter" />
            <short value="An associated encounter reference" />
            <definition value="An associated encounter reference." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="DomainResource.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/encounter-associatedEncounter" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mustSupport value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.extension:allergyEnd">
            <path value="AllergyIntolerance.extension" />
            <sliceName value="allergyEnd" />
            <short value="Supports the date and reason that the allergy was no longer valid" />
            <definition value="Supports the date and reason that the allergy was no longer valid." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="DomainResource.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-AllergyIntoleranceEnd-1" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mustSupport value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.extension:evidence">
            <path value="AllergyIntolerance.extension" />
            <sliceName value="evidence" />
            <short value="A reference to results of investigations that confirmed the certainty of the diagnosis" />
            <definition value="A reference to results of investigations that confirmed the certainty of the diagnosis." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="DomainResource.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-Evidence-1" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.modifierExtension">
            <path value="AllergyIntolerance.modifierExtension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Extensions that cannot be ignored" />
            <definition value="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. Usually modifier elements provide negation or qualification. In order 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="DomainResource.modifierExtension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <isModifier value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.identifier">
            <path value="AllergyIntolerance.identifier" />
            <short value="External ids for this item" />
            <definition value="This records identifiers associated with this allergy/intolerance concern that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation)." />
            <min value="1" />
            <max value="*" />
            <base>
                <path value="AllergyIntolerance.identifier" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Identifier" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="Identifier" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="IAM-7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="id" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="id" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.identifier.id">
            <path value="AllergyIntolerance.identifier.id" />
            <representation value="xmlAttr" />
            <short value="xml:id (or equivalent in JSON)" />
            <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.identifier.extension">
            <path value="AllergyIntolerance.identifier.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional Content defined by implementations" />
            <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.identifier.use">
            <path value="AllergyIntolerance.identifier.use" />
            <short value="usual | official | temp | secondary (If known)" />
            <definition value="The purpose of this identifier." />
            <comment value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
            <requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Identifier.use" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isModifier value="true" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="IdentifierUse" />
                </extension>
                <strength value="required" />
                <description value="Identifies the purpose for this identifier, if known ." />
                <valueSetReference>
                    <reference value="http://hl7.org/fhir/ValueSet/identifier-use" />
                </valueSetReference>
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Role.code or implied by context" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.identifier.type">
            <path value="AllergyIntolerance.identifier.type" />
            <short value="Description of identifier" />
            <definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
            <comment value="This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. \n\nWhere the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type." />
            <requirements value="Allows users to make use of identifiers when the identifier system is not known." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Identifier.type" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="IdentifierType" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
                    <valueBoolean value="true" />
                </extension>
                <strength value="extensible" />
                <description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
                <valueSetReference>
                    <reference value="http://hl7.org/fhir/ValueSet/identifier-type" />
                </valueSetReference>
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CX.5" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Role.code or implied by context" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.identifier.system">
            <path value="AllergyIntolerance.identifier.system" />
            <short value="The namespace for the identifier value" />
            <definition value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique." />
            <comment value="see http://en.wikipedia.org/wiki/Uniform_resource_identifier" />
            <requirements value="There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we&#39;re dealing with. The system identifies a particular set of unique identifiers." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Identifier.system" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <example>
                <label value="General" />
                <valueUri value="http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri" />
            </example>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CX.4 / EI-2-4" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="II.root or Role.id.root" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./IdentifierType" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.identifier.value">
            <path value="AllergyIntolerance.identifier.value" />
            <short value="The value that is unique" />
            <definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
            <comment value="If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value&#39;s primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html)." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Identifier.value" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <example>
                <label value="General" />
                <valueString value="123456" />
            </example>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CX.1 / EI.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./Value" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.identifier.period">
            <path value="AllergyIntolerance.identifier.period" />
            <short value="Time period when id is/was valid for use" />
            <definition value="Time period during which identifier is/was valid for use." />
            <comment value="This is not a duration - that&#39;s a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. &quot;the patient was an inpatient of the hospital for this time range&quot;) or one value from the range applies (e.g. &quot;give to the patient between these two times&quot;). If duration is required, specify the type as Interval|Duration." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Identifier.period" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Period" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="per-1" />
                <severity value="error" />
                <human value="If present, start SHALL have a lower value than end" />
                <expression value="start.empty() or end.empty() or (start &lt;= end)" />
                <xpath value="not(exists(f:start)) or not(exists(f:end)) or (f:start/@value &lt;= f:end/@value)" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="DR" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="IVL&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;] or URG&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;]" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CX.7 + CX.8" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Role.effectiveTime or implied by context" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./StartDate and ./EndDate" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.identifier.assigner">
            <path value="AllergyIntolerance.identifier.assigner" />
            <short value="Organization that issued id (may be just text)" />
            <definition value="Organization that issued/manages the identifier." />
            <comment value="The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Identifier.assigner" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %resource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CX.4 / (CX.4,CX.9,CX.10)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="./IdentifierIssuingAuthority" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.clinicalStatus">
            <path value="AllergyIntolerance.clinicalStatus" />
            <short value="active | inactive | resolved" />
            <definition value="The clinical status of the allergy or intolerance." />
            <comment value="This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as not currently valid." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="AllergyIntolerance.clinicalStatus" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <condition value="ele-1" />
            <condition value="ait-1" />
            <condition value="ait-2" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isModifier value="true" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="AllergyIntoleranceClinicalStatus" />
                </extension>
                <strength value="required" />
                <description value="The clinical status of the allergy or intolerance." />
                <valueSetReference>
                    <reference value="http://hl7.org/fhir/ValueSet/allergy-clinical-status" />
                </valueSetReference>
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=&quot;clinicalStatus&quot;, moodCode=EVN].value" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="status" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.verificationStatus">
            <path value="AllergyIntolerance.verificationStatus" />
            <short value="unconfirmed | confirmed" />
            <definition value="Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product)." />
            <comment value="This element is labeled as a modifier because the status contains the codes refuted and entered-in-error that mark the AllergyIntolerance as not currently valid." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="AllergyIntolerance.verificationStatus" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <fixedCode value="unconfirmed" />
            <condition value="ele-1" />
            <condition value="ait-1" />
            <condition value="ait-2" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isModifier value="true" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="AllergyIntoleranceVerificationStatus" />
                </extension>
                <strength value="required" />
                <description value="Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance." />
                <valueSetReference>
                    <reference value="http://hl7.org/fhir/ValueSet/allergy-verification-status" />
                </valueSetReference>
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=&quot;verificationStatus&quot;, moodCode=EVN].value" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="status" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.type">
            <path value="AllergyIntolerance.type" />
            <short value="allergy | intolerance - Underlying mechanism (if known)" />
            <definition value="Identification of the underlying physiological mechanism for the reaction risk." />
            <comment value="Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term &quot;allergy&quot; is used rather generically and may overlap with the use of &quot;intolerance&quot; - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource." />
            <alias value="Category" />
            <alias value="Class" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="AllergyIntolerance.type" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="AllergyIntoleranceType" />
                </extension>
                <strength value="required" />
                <description value="Identification of the underlying physiological mechanism for a Reaction Risk." />
                <valueSetReference>
                    <reference value="http://hl7.org/fhir/ValueSet/allergy-intolerance-type" />
                </valueSetReference>
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="IAM-9" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="code" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="class" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.category">
            <path value="AllergyIntolerance.category" />
            <short value="food | medication | environment | biologic" />
            <definition value="Category of the identified substance." />
            <comment value="This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation.  When searching on category, consider the implications of AllergyIntolerance resources without a category.  For example, when searching on category = medication, medication allergies that don&#39;t have a category valued will not be returned.  Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don&#39;t have a category.  Additionally, category should be used with caution because category can be subjective based on the sender." />
            <alias value="Category" />
            <alias value="Type" />
            <alias value="Reaction Type" />
            <alias value="Class" />
            <min value="1" />
            <max value="*" />
            <base>
                <path value="AllergyIntolerance.category" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="code" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="AllergyIntoleranceCategory" />
                </extension>
                <strength value="required" />
                <description value="Category of an identified substance." />
                <valueSetReference>
                    <reference value="http://hl7.org/fhir/ValueSet/allergy-intolerance-category" />
                </valueSetReference>
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="AL1-2" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="value &lt; IntoleranceValue (Agent)" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="class" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.criticality">
            <path value="AllergyIntolerance.criticality" />
            <short value="low | high | unable-to-assess" />
            <definition value="Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance." />
            <comment value="The default criticality value for any propensity to an adverse reaction should be &#39;Low Risk&#39;, indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. &#39;High Risk&#39; is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).\n\nSystems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity.  Existing systems that are capturing both condition criticality and reaction severity may use the term &quot;severity&quot; to represent both.  Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent." />
            <alias value="Severity" />
            <alias value="Seriousness" />
            <alias value="Contra-indication" />
            <alias value="Risk" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="AllergyIntolerance.criticality" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="AllergyIntoleranceCriticality" />
                </extension>
                <strength value="required" />
                <description value="Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance." />
                <valueSetReference>
                    <reference value="http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality" />
                </valueSetReference>
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="AL1-4" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value &lt;= SeverityObservation (Severity Level)]" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="grade" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.code">
            <path value="AllergyIntolerance.code" />
            <short value="Code that identifies the allergy or intolerance" />
            <definition value="Code for an allergy or intolerance statement (either a positive or a negated/excluded statement).  This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., &quot;Latex&quot;), an allergy or intolerance condition (e.g., &quot;Latex allergy&quot;), or a negated/excluded code for a specific substance or class (e.g., &quot;No latex allergy&quot;) or a general or categorical negated statement (e.g.,  &quot;No known allergy&quot;, &quot;No known drug allergies&quot;)." />
            <comment value="It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.\n\nWhen a substance or product code is specified for the &#39;code&#39; element, the &quot;default&quot; semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the &#39;type&#39; element, if present) condition to the specified substance/product.  In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the &quot;Causative agent&quot; relationship.\n\nThe &#39;substanceExposureRisk&#39; extension is available as a structured and more flexible alternative to the &#39;code&#39; element for making positive or negative allergy or intolerance statements.  This extension provides the capability to make &quot;no known allergy&quot; (or &quot;no risk of adverse reaction&quot;) statements regarding any coded substance/product (including cases when a pre-coordinated &quot;no allergy to x&quot; concept for that substance/product does not exist).  If the &#39;substanceExposureRisk&#39; extension is present, the AllergyIntolerance.code element SHALL be omitted." />
            <alias value="Code" />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="AllergyIntolerance.code" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="AllergyIntoleranceCode" />
                </extension>
                <strength value="example" />
                <description value="Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies." />
                <valueSetReference>
                    <reference value="https://fhir.nhs.uk/STU3/ValueSet/CareConnect-AllergyCode-1" />
                </valueSetReference>
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="AL1-3 / IAM-3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="substance/product:\n\n.participation[typeCode=CAGNT].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code &lt;= ExposureAgentEntityType]\n\nnegated/excluded substance/product:\n\n.participation[typeCode=CAGNT, negationInd=true].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code &lt;= ExposureAgentEntityType]\n\npositive or negated/excluded condition/situation:\n\nObservation.code=ASSERTION; Observation.value" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="what" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.code.id">
            <path value="AllergyIntolerance.code.id" />
            <representation value="xmlAttr" />
            <short value="xml:id (or equivalent in JSON)" />
            <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.code.extension">
            <path value="AllergyIntolerance.code.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional Content defined by implementations" />
            <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.code.coding">
            <path value="AllergyIntolerance.code.coding" />
            <short value="Code defined by a terminology system" />
            <definition value="A reference to a code defined by a terminology system." />
            <comment value="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." />
            <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="CodeableConcept.coding" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Coding" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.1-8, C*E.10-22" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="union(., ./translation)" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.code.coding.id">
            <path value="AllergyIntolerance.code.coding.id" />
            <representation value="xmlAttr" />
            <short value="xml:id (or equivalent in JSON)" />
            <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.code.coding.extension">
            <path value="AllergyIntolerance.code.coding.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional Content defined by implementations" />
            <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.code.coding.extension:snomedCTDescriptionID">
            <path value="AllergyIntolerance.code.coding.extension" />
            <sliceName value="snomedCTDescriptionID" />
            <short value="The SNOMED CT Description ID for the display" />
            <definition value="The SNOMED CT Description ID for the display." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.code.coding.system">
            <path value="AllergyIntolerance.code.coding.system" />
            <short value="Identity of the terminology system" />
            <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
            <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7&#39;s list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." />
            <requirements value="Need to be unambiguous about the source of the definition of the symbol." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Coding.system" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./codeSystem" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.code.coding.version">
            <path value="AllergyIntolerance.code.coding.version" />
            <short value="Version of the system - if relevant" />
            <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
            <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Coding.version" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./codeSystemVersion" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.code.coding.code">
            <path value="AllergyIntolerance.code.coding.code" />
            <short value="Symbol in syntax defined by the system" />
            <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <requirements value="Need to refer to a particular code in the system." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Coding.code" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./code" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.code.coding.display">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="AllergyIntolerance.code.coding.display" />
            <short value="Representation defined by the system" />
            <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.display" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.2 - but note this is not well followed" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV.displayName" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.code.coding.userSelected">
            <path value="AllergyIntolerance.code.coding.userSelected" />
            <short value="If this coding was chosen directly by the user" />
            <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." />
            <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly &#39;directly chosen&#39; implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." />
            <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.userSelected" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="Sometimes implied by being first" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD.codingRationale" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.code.text">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="AllergyIntolerance.code.text" />
            <short value="Plain text representation of the concept" />
            <definition value="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." />
            <comment value="Very often the text is the same as a displayName of one of the codings." />
            <requirements value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="CodeableConcept.text" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.9. But note many systems use C*E.2 for this" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.patient">
            <path value="AllergyIntolerance.patient" />
            <short value="Who the sensitivity is for" />
            <definition value="The patient who has the allergy or intolerance." />
            <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
            <alias value="Patient" />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="AllergyIntolerance.patient" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %resource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="(PID-3)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=SBJ].role[classCode=PAT]" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="who.focus" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.onset[x]">
            <path value="AllergyIntolerance.onset[x]" />
            <short value="When allergy or intolerance was identified" />
            <definition value="Estimated or actual date,  date-time, or age when allergy or intolerance was identified." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="AllergyIntolerance.onset[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <type>
                <code value="Age" />
            </type>
            <type>
                <code value="Period" />
            </type>
            <type>
                <code value="Range" />
            </type>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mustSupport value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="effectiveTime.low" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="when.init" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.assertedDate">
            <path value="AllergyIntolerance.assertedDate" />
            <short value="Date record was believed accurate" />
            <definition value="The date on which the existance of the AllergyIntolerance was first asserted or acknowledged." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="AllergyIntolerance.assertedDate" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="IAM-20" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=AUT].time" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="when.recorded" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.recorder">
            <path value="AllergyIntolerance.recorder" />
            <short value="Who recorded the sensitivity" />
            <definition value="Individual who recorded the record and takes responsibility for its content." />
            <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
            <alias value="Author" />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="AllergyIntolerance.recorder" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %resource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=AUT].role" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="who.author" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.asserter">
            <path value="AllergyIntolerance.asserter" />
            <short value="Source of the information about the allergy" />
            <definition value="The source of the information about the allergy that is recorded." />
            <comment value="The recorder takes repsonsibility for the content, but can reference the source from where they got it." />
            <alias value="Source" />
            <alias value="Informant" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="AllergyIntolerance.asserter" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %resource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
            </constraint>
            <mustSupport value="true" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="IAM-14 (if patient) / IAM-18 (if practitioner)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=INF].role" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="who.source" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.lastOccurrence">
            <path value="AllergyIntolerance.lastOccurrence" />
            <short value="Date(/time) of last known occurrence of a reaction" />
            <definition value="Represents the date and/or time of the last known occurrence of a reaction event." />
            <comment value="This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. &#39;In Childhood, &#39;10 years ago&#39; the Comment element should be used." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="AllergyIntolerance.lastOccurrence" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code &lt;= CommonClinicalObservationType, value &lt;= ObservationValue (Reaction Type)].effectiveTime" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.note">
            <path value="AllergyIntolerance.note" />
            <short value="Additional text not captured in other fields" />
            <definition value="Additional narrative about the propensity for the Adverse Reaction, not captured in other fields." />
            <comment value="For example: including reason for flagging a seriousness of &#39;High Risk&#39;; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and  AllergyIntolerance.event.notes." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="AllergyIntolerance.note" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Annotation" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mustSupport value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Act" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="subjectOf.observationEvent[code=&quot;annotation&quot;].value" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.note.id">
            <path value="AllergyIntolerance.note.id" />
            <representation value="xmlAttr" />
            <short value="xml:id (or equivalent in JSON)" />
            <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.note.extension">
            <path value="AllergyIntolerance.note.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional Content defined by implementations" />
            <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.note.author[x]">
            <path value="AllergyIntolerance.note.author[x]" />
            <short value="Individual responsible for the annotation" />
            <definition value="The individual responsible for making the annotation." />
            <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Annotation.author[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
            </type>
            <type>
                <code value="string" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %resource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Act.participant[typeCode=AUT].role" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.note.time">
            <path value="AllergyIntolerance.note.time" />
            <short value="When the annotation was made" />
            <definition value="Indicates when this particular annotation was made." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Annotation.time" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Act.effectiveTime" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.note.text">
            <path value="AllergyIntolerance.note.text" />
            <short value="The annotation  - text content" />
            <definition value="The text of the annotation." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Annotation.text" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Act.text" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction">
            <path value="AllergyIntolerance.reaction" />
            <short value="Adverse Reaction Events linked to exposure to substance" />
            <definition value="Details about each adverse reaction event linked to exposure to the identified substance." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="AllergyIntolerance.reaction" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="BackboneElement" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code &lt;= CommonClinicalObservationType, value &lt;= ObservationValue (Reaction Type)]" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.id">
            <path value="AllergyIntolerance.reaction.id" />
            <representation value="xmlAttr" />
            <short value="xml:id (or equivalent in JSON)" />
            <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.extension">
            <path value="AllergyIntolerance.reaction.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional Content defined by implementations" />
            <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.modifierExtension">
            <path value="AllergyIntolerance.reaction.modifierExtension" />
            <short value="Extensions that cannot be ignored" />
            <definition value="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 that contains it. Usually modifier elements provide negation or qualification. In order 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <alias value="modifiers" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="BackboneElement.modifierExtension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <isModifier value="true" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.substance">
            <path value="AllergyIntolerance.reaction.substance" />
            <short value="Specific substance or pharmaceutical product considered to be responsible for event" />
            <definition value="Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the &#39;code&#39; and ignore the &#39;reaction.substance&#39;." />
            <comment value="Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible.  The &#39;code&#39; element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, &quot;penicillins&quot;), the &#39;reaction.substance&#39; element could be used to code the specific substance that was identifed as having caused the reaction (for example, &quot;amoxycillin&quot;). Duplication of the value in the &#39;code&#39; and &#39;reaction.substance&#39; elements is acceptable when a specific substance has been recorded in &#39;code&#39;." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="AllergyIntolerance.reaction.substance" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="SubstanceCode" />
                </extension>
                <strength value="example" />
                <description value="Codes defining the type of the substance (including pharmaceutical products)." />
                <valueSetReference>
                    <reference value="http://hl7.org/fhir/ValueSet/substance-code" />
                </valueSetReference>
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code &lt;= ExposureCode].participation[typeCode=CSM].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code &lt;= ExposureAgentEntityType]" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.substance.id">
            <path value="AllergyIntolerance.reaction.substance.id" />
            <representation value="xmlAttr" />
            <short value="xml:id (or equivalent in JSON)" />
            <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.substance.extension">
            <path value="AllergyIntolerance.reaction.substance.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional Content defined by implementations" />
            <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.substance.coding">
            <path value="AllergyIntolerance.reaction.substance.coding" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="system" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
            <short value="Code defined by a terminology system" />
            <definition value="A reference to a code defined by a terminology system." />
            <comment value="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." />
            <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="CodeableConcept.coding" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Coding" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.1-8, C*E.10-22" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="union(., ./translation)" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.substance.coding:snomedCT">
            <path value="AllergyIntolerance.reaction.substance.coding" />
            <sliceName value="snomedCT" />
            <short value="Code defined by a terminology system" />
            <definition value="A reference to a code defined by a terminology system." />
            <comment value="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." />
            <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="CodeableConcept.coding" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Coding" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.1-8, C*E.10-22" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="union(., ./translation)" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.substance.coding:snomedCT.id">
            <path value="AllergyIntolerance.reaction.substance.coding.id" />
            <representation value="xmlAttr" />
            <short value="xml:id (or equivalent in JSON)" />
            <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.substance.coding:snomedCT.extension">
            <path value="AllergyIntolerance.reaction.substance.coding.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional Content defined by implementations" />
            <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID">
            <path value="AllergyIntolerance.reaction.substance.coding.extension" />
            <sliceName value="snomedCTDescriptionID" />
            <short value="The SNOMED CT Description ID for the display" />
            <definition value="The SNOMED CT Description ID for the display." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.substance.coding:snomedCT.system">
            <path value="AllergyIntolerance.reaction.substance.coding.system" />
            <short value="Identity of the terminology system" />
            <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
            <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7&#39;s list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." />
            <requirements value="Need to be unambiguous about the source of the definition of the symbol." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Coding.system" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <fixedUri value="http://snomed.info/sct" />
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./codeSystem" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.substance.coding:snomedCT.version">
            <path value="AllergyIntolerance.reaction.substance.coding.version" />
            <short value="Version of the system - if relevant" />
            <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
            <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Coding.version" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./codeSystemVersion" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.substance.coding:snomedCT.code">
            <path value="AllergyIntolerance.reaction.substance.coding.code" />
            <short value="Symbol in syntax defined by the system" />
            <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <requirements value="Need to refer to a particular code in the system." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Coding.code" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./code" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.substance.coding:snomedCT.display">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="AllergyIntolerance.reaction.substance.coding.display" />
            <short value="Representation defined by the system" />
            <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.display" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.2 - but note this is not well followed" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV.displayName" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.substance.coding:snomedCT.userSelected">
            <path value="AllergyIntolerance.reaction.substance.coding.userSelected" />
            <short value="If this coding was chosen directly by the user" />
            <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." />
            <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly &#39;directly chosen&#39; implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." />
            <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.userSelected" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="Sometimes implied by being first" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD.codingRationale" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.substance.text">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="AllergyIntolerance.reaction.substance.text" />
            <short value="Plain text representation of the concept" />
            <definition value="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." />
            <comment value="Very often the text is the same as a displayName of one of the codings." />
            <requirements value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="CodeableConcept.text" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.9. But note many systems use C*E.2 for this" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.manifestation">
            <path value="AllergyIntolerance.reaction.manifestation" />
            <short value="Clinical symptoms/signs associated with the Event" />
            <definition value="Clinical symptoms and/or signs that are observed or associated with the adverse reaction event." />
            <comment value="Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.  Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10." />
            <alias value="Symptoms" />
            <alias value="Signs" />
            <min value="1" />
            <max value="*" />
            <base>
                <path value="AllergyIntolerance.reaction.manifestation" />
                <min value="1" />
                <max value="*" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="Manifestation" />
                </extension>
                <strength value="extensible" />
                <description value="Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event." />
                <valueSetReference>
                    <reference value="https://fhir.hl7.org.uk/STU3/ValueSet/CareConnect-AllergyManifestation-1" />
                </valueSetReference>
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="AL1-5" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="code" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.id">
            <path value="AllergyIntolerance.reaction.manifestation.id" />
            <representation value="xmlAttr" />
            <short value="xml:id (or equivalent in JSON)" />
            <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.extension">
            <path value="AllergyIntolerance.reaction.manifestation.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional Content defined by implementations" />
            <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.coding">
            <path value="AllergyIntolerance.reaction.manifestation.coding" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="system" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
            <short value="Code defined by a terminology system" />
            <definition value="A reference to a code defined by a terminology system." />
            <comment value="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." />
            <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="CodeableConcept.coding" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Coding" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.1-8, C*E.10-22" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="union(., ./translation)" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT">
            <path value="AllergyIntolerance.reaction.manifestation.coding" />
            <sliceName value="snomedCT" />
            <short value="Code defined by a terminology system" />
            <definition value="A reference to a code defined by a terminology system." />
            <comment value="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." />
            <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="CodeableConcept.coding" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Coding" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.1-8, C*E.10-22" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="union(., ./translation)" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT.id">
            <path value="AllergyIntolerance.reaction.manifestation.coding.id" />
            <representation value="xmlAttr" />
            <short value="xml:id (or equivalent in JSON)" />
            <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension">
            <path value="AllergyIntolerance.reaction.manifestation.coding.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional Content defined by implementations" />
            <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID">
            <path value="AllergyIntolerance.reaction.manifestation.coding.extension" />
            <sliceName value="snomedCTDescriptionID" />
            <short value="The SNOMED CT Description ID for the display" />
            <definition value="The SNOMED CT Description ID for the display." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT.system">
            <path value="AllergyIntolerance.reaction.manifestation.coding.system" />
            <short value="Identity of the terminology system" />
            <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
            <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7&#39;s list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." />
            <requirements value="Need to be unambiguous about the source of the definition of the symbol." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Coding.system" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <fixedUri value="http://snomed.info/sct" />
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./codeSystem" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT.version">
            <path value="AllergyIntolerance.reaction.manifestation.coding.version" />
            <short value="Version of the system - if relevant" />
            <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
            <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Coding.version" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./codeSystemVersion" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT.code">
            <path value="AllergyIntolerance.reaction.manifestation.coding.code" />
            <short value="Symbol in syntax defined by the system" />
            <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <requirements value="Need to refer to a particular code in the system." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Coding.code" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./code" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT.display">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="AllergyIntolerance.reaction.manifestation.coding.display" />
            <short value="Representation defined by the system" />
            <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.display" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.2 - but note this is not well followed" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV.displayName" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT.userSelected">
            <path value="AllergyIntolerance.reaction.manifestation.coding.userSelected" />
            <short value="If this coding was chosen directly by the user" />
            <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." />
            <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly &#39;directly chosen&#39; implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." />
            <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.userSelected" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="Sometimes implied by being first" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD.codingRationale" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.text">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="AllergyIntolerance.reaction.manifestation.text" />
            <short value="Plain text representation of the concept" />
            <definition value="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." />
            <comment value="Very often the text is the same as a displayName of one of the codings." />
            <requirements value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="CodeableConcept.text" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.9. But note many systems use C*E.2 for this" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.description">
            <path value="AllergyIntolerance.reaction.description" />
            <short value="Description of the event as a whole" />
            <definition value="Text description about the reaction as a whole, including details of the manifestation if required." />
            <comment value="Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives." />
            <alias value="Narrative" />
            <alias value="Text" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="AllergyIntolerance.reaction.description" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="text" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.onset">
            <path value="AllergyIntolerance.reaction.onset" />
            <short value="Date(/time) when manifestations showed" />
            <definition value="Record of the date and/or time of the onset of the Reaction." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="AllergyIntolerance.reaction.onset" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="AL1-6" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="effectiveTime.low" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.severity">
            <path value="AllergyIntolerance.reaction.severity" />
            <short value="mild | moderate | severe (of event as a whole)" />
            <definition value="Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations." />
            <comment value="It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="AllergyIntolerance.reaction.severity" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mustSupport value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="AllergyIntoleranceSeverity" />
                </extension>
                <strength value="required" />
                <description value="Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations." />
                <valueSetReference>
                    <reference value="http://hl7.org/fhir/ValueSet/reaction-event-severity" />
                </valueSetReference>
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value &lt;= SeverityObservation (Severity Level)]" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute">
            <path value="AllergyIntolerance.reaction.exposureRoute" />
            <short value="How the subject was exposed to the substance" />
            <definition value="Identification of the route by which the subject was exposed to the substance." />
            <comment value="Coding of the route of exposure with a terminology should be used wherever possible." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="AllergyIntolerance.reaction.exposureRoute" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="RouteOfAdministration" />
                </extension>
                <strength value="example" />
                <description value="A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject." />
                <valueSetReference>
                    <reference value="https://fhir.nhs.uk/STU3/ValueSet/CareConnect-AllergyExposureRoute-1" />
                </valueSetReference>
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code &lt;= ExposureCode].routeCode" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.id">
            <path value="AllergyIntolerance.reaction.exposureRoute.id" />
            <representation value="xmlAttr" />
            <short value="xml:id (or equivalent in JSON)" />
            <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.extension">
            <path value="AllergyIntolerance.reaction.exposureRoute.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional Content defined by implementations" />
            <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.coding">
            <path value="AllergyIntolerance.reaction.exposureRoute.coding" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="system" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
            <short value="Code defined by a terminology system" />
            <definition value="A reference to a code defined by a terminology system." />
            <comment value="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." />
            <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="CodeableConcept.coding" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Coding" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.1-8, C*E.10-22" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="union(., ./translation)" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT">
            <path value="AllergyIntolerance.reaction.exposureRoute.coding" />
            <sliceName value="snomedCT" />
            <short value="Code defined by a terminology system" />
            <definition value="A reference to a code defined by a terminology system." />
            <comment value="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." />
            <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="CodeableConcept.coding" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Coding" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.1-8, C*E.10-22" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="union(., ./translation)" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.id">
            <path value="AllergyIntolerance.reaction.exposureRoute.coding.id" />
            <representation value="xmlAttr" />
            <short value="xml:id (or equivalent in JSON)" />
            <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension">
            <path value="AllergyIntolerance.reaction.exposureRoute.coding.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional Content defined by implementations" />
            <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID">
            <path value="AllergyIntolerance.reaction.exposureRoute.coding.extension" />
            <sliceName value="snomedCTDescriptionID" />
            <short value="The SNOMED CT Description ID for the display" />
            <definition value="The SNOMED CT Description ID for the display." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.system">
            <path value="AllergyIntolerance.reaction.exposureRoute.coding.system" />
            <short value="Identity of the terminology system" />
            <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
            <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7&#39;s list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." />
            <requirements value="Need to be unambiguous about the source of the definition of the symbol." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Coding.system" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <fixedUri value="http://snomed.info/sct" />
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./codeSystem" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.version">
            <path value="AllergyIntolerance.reaction.exposureRoute.coding.version" />
            <short value="Version of the system - if relevant" />
            <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
            <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Coding.version" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./codeSystemVersion" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.code">
            <path value="AllergyIntolerance.reaction.exposureRoute.coding.code" />
            <short value="Symbol in syntax defined by the system" />
            <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <requirements value="Need to refer to a particular code in the system." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Coding.code" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./code" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.display">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="AllergyIntolerance.reaction.exposureRoute.coding.display" />
            <short value="Representation defined by the system" />
            <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.display" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.2 - but note this is not well followed" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV.displayName" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.userSelected">
            <path value="AllergyIntolerance.reaction.exposureRoute.coding.userSelected" />
            <short value="If this coding was chosen directly by the user" />
            <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." />
            <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly &#39;directly chosen&#39; implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." />
            <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.userSelected" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="Sometimes implied by being first" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD.codingRationale" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.text">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="AllergyIntolerance.reaction.exposureRoute.text" />
            <short value="Plain text representation of the concept" />
            <definition value="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." />
            <comment value="Very often the text is the same as a displayName of one of the codings." />
            <requirements value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="CodeableConcept.text" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.9. But note many systems use C*E.2 for this" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.note">
            <path value="AllergyIntolerance.reaction.note" />
            <short value="Text about event not captured in other fields" />
            <definition value="Additional text about the adverse reaction event not captured in other fields." />
            <comment value="Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="AllergyIntolerance.reaction.note" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Annotation" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Act" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="subjectOf.observationEvent[code=&quot;annotation&quot;].value" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.note.id">
            <path value="AllergyIntolerance.reaction.note.id" />
            <representation value="xmlAttr" />
            <short value="xml:id (or equivalent in JSON)" />
            <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.note.extension">
            <path value="AllergyIntolerance.reaction.note.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional Content defined by implementations" />
            <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.note.author[x]">
            <path value="AllergyIntolerance.reaction.note.author[x]" />
            <short value="Individual responsible for the annotation" />
            <definition value="The individual responsible for making the annotation." />
            <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Annotation.author[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
            </type>
            <type>
                <code value="string" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <constraint>
                <key value="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %resource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Act.participant[typeCode=AUT].role" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.note.time">
            <path value="AllergyIntolerance.reaction.note.time" />
            <short value="When the annotation was made" />
            <definition value="Indicates when this particular annotation was made." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Annotation.time" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Act.effectiveTime" />
            </mapping>
        </element>
        <element id="AllergyIntolerance.reaction.note.text">
            <path value="AllergyIntolerance.reaction.note.text" />
            <short value="The annotation  - text content" />
            <definition value="The text of the annotation." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Annotation.text" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() | (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Act.text" />
            </mapping>
        </element>
    </snapshot>
    <differential>
        <element id="AllergyIntolerance.meta.profile">
            <path value="AllergyIntolerance.meta.profile" />
            <min value="1" />
        </element>
        <element id="AllergyIntolerance.extension">
            <path value="AllergyIntolerance.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <rules value="open" />
            </slicing>
        </element>
        <element id="AllergyIntolerance.extension:encounter">
            <path value="AllergyIntolerance.extension" />
            <sliceName value="encounter" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/encounter-associatedEncounter" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="AllergyIntolerance.extension:allergyEnd">
            <path value="AllergyIntolerance.extension" />
            <sliceName value="allergyEnd" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-AllergyIntoleranceEnd-1" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="AllergyIntolerance.extension:evidence">
            <path value="AllergyIntolerance.extension" />
            <sliceName value="evidence" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-Evidence-1" />
            </type>
        </element>
        <element id="AllergyIntolerance.identifier">
            <path value="AllergyIntolerance.identifier" />
            <min value="1" />
        </element>
        <element id="AllergyIntolerance.identifier.system">
            <path value="AllergyIntolerance.identifier.system" />
            <min value="1" />
        </element>
        <element id="AllergyIntolerance.identifier.value">
            <path value="AllergyIntolerance.identifier.value" />
            <min value="1" />
        </element>
        <element id="AllergyIntolerance.clinicalStatus">
            <path value="AllergyIntolerance.clinicalStatus" />
            <min value="1" />
        </element>
        <element id="AllergyIntolerance.verificationStatus">
            <path value="AllergyIntolerance.verificationStatus" />
            <short value="unconfirmed | confirmed" />
            <fixedCode value="unconfirmed" />
        </element>
        <element id="AllergyIntolerance.category">
            <path value="AllergyIntolerance.category" />
            <min value="1" />
        </element>
        <element id="AllergyIntolerance.code">
            <path value="AllergyIntolerance.code" />
            <min value="1" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="AllergyIntoleranceCode" />
                </extension>
                <strength value="example" />
                <valueSetReference>
                    <reference value="https://fhir.nhs.uk/STU3/ValueSet/CareConnect-AllergyCode-1" />
                </valueSetReference>
            </binding>
        </element>
        <element id="AllergyIntolerance.code.coding.extension">
            <path value="AllergyIntolerance.code.coding.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <rules value="open" />
            </slicing>
        </element>
        <element id="AllergyIntolerance.code.coding.extension:snomedCTDescriptionID">
            <path value="AllergyIntolerance.code.coding.extension" />
            <sliceName value="snomedCTDescriptionID" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid" />
            </type>
        </element>
        <element id="AllergyIntolerance.code.coding.system">
            <path value="AllergyIntolerance.code.coding.system" />
            <min value="1" />
        </element>
        <element id="AllergyIntolerance.code.coding.version">
            <path value="AllergyIntolerance.code.coding.version" />
            <max value="0" />
        </element>
        <element id="AllergyIntolerance.code.coding.code">
            <path value="AllergyIntolerance.code.coding.code" />
            <min value="1" />
        </element>
        <element id="AllergyIntolerance.patient">
            <path value="AllergyIntolerance.patient" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
            </type>
        </element>
        <element id="AllergyIntolerance.onset[x]">
            <path value="AllergyIntolerance.onset[x]" />
            <mustSupport value="true" />
        </element>
        <element id="AllergyIntolerance.assertedDate">
            <path value="AllergyIntolerance.assertedDate" />
            <min value="1" />
        </element>
        <element id="AllergyIntolerance.recorder">
            <path value="AllergyIntolerance.recorder" />
            <min value="1" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1" />
            </type>
        </element>
        <element id="AllergyIntolerance.asserter">
            <path value="AllergyIntolerance.asserter" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="AllergyIntolerance.note">
            <path value="AllergyIntolerance.note" />
            <mustSupport value="true" />
        </element>
        <element id="AllergyIntolerance.note.author[x]">
            <path value="AllergyIntolerance.note.author[x]" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
            </type>
            <type>
                <code value="string" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1" />
            </type>
        </element>
        <element id="AllergyIntolerance.reaction.substance.coding">
            <path value="AllergyIntolerance.reaction.substance.coding" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="system" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
        </element>
        <element id="AllergyIntolerance.reaction.substance.coding:snomedCT">
            <path value="AllergyIntolerance.reaction.substance.coding" />
            <sliceName value="snomedCT" />
            <max value="1" />
        </element>
        <element id="AllergyIntolerance.reaction.substance.coding:snomedCT.extension">
            <path value="AllergyIntolerance.reaction.substance.coding.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <rules value="open" />
            </slicing>
        </element>
        <element id="AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID">
            <path value="AllergyIntolerance.reaction.substance.coding.extension" />
            <sliceName value="snomedCTDescriptionID" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid" />
            </type>
        </element>
        <element id="AllergyIntolerance.reaction.substance.coding:snomedCT.system">
            <path value="AllergyIntolerance.reaction.substance.coding.system" />
            <min value="1" />
            <fixedUri value="http://snomed.info/sct" />
        </element>
        <element id="AllergyIntolerance.reaction.substance.coding:snomedCT.version">
            <path value="AllergyIntolerance.reaction.substance.coding.version" />
            <max value="0" />
        </element>
        <element id="AllergyIntolerance.reaction.substance.coding:snomedCT.code">
            <path value="AllergyIntolerance.reaction.substance.coding.code" />
            <min value="1" />
        </element>
        <element id="AllergyIntolerance.reaction.manifestation">
            <path value="AllergyIntolerance.reaction.manifestation" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="Manifestation" />
                </extension>
                <strength value="extensible" />
                <valueSetReference>
                    <reference value="https://fhir.hl7.org.uk/STU3/ValueSet/CareConnect-AllergyManifestation-1" />
                </valueSetReference>
            </binding>
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.coding">
            <path value="AllergyIntolerance.reaction.manifestation.coding" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="system" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT">
            <path value="AllergyIntolerance.reaction.manifestation.coding" />
            <sliceName value="snomedCT" />
            <max value="1" />
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension">
            <path value="AllergyIntolerance.reaction.manifestation.coding.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <rules value="open" />
            </slicing>
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID">
            <path value="AllergyIntolerance.reaction.manifestation.coding.extension" />
            <sliceName value="snomedCTDescriptionID" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid" />
            </type>
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT.system">
            <path value="AllergyIntolerance.reaction.manifestation.coding.system" />
            <min value="1" />
            <fixedUri value="http://snomed.info/sct" />
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT.version">
            <path value="AllergyIntolerance.reaction.manifestation.coding.version" />
            <max value="0" />
        </element>
        <element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT.code">
            <path value="AllergyIntolerance.reaction.manifestation.coding.code" />
            <min value="1" />
        </element>
        <element id="AllergyIntolerance.reaction.severity">
            <path value="AllergyIntolerance.reaction.severity" />
            <mustSupport value="true" />
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute">
            <path value="AllergyIntolerance.reaction.exposureRoute" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="RouteOfAdministration" />
                </extension>
                <strength value="example" />
                <valueSetReference>
                    <reference value="https://fhir.nhs.uk/STU3/ValueSet/CareConnect-AllergyExposureRoute-1" />
                </valueSetReference>
            </binding>
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.coding">
            <path value="AllergyIntolerance.reaction.exposureRoute.coding" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="system" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT">
            <path value="AllergyIntolerance.reaction.exposureRoute.coding" />
            <sliceName value="snomedCT" />
            <max value="1" />
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension">
            <path value="AllergyIntolerance.reaction.exposureRoute.coding.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <rules value="open" />
            </slicing>
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID">
            <path value="AllergyIntolerance.reaction.exposureRoute.coding.extension" />
            <sliceName value="snomedCTDescriptionID" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid" />
            </type>
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.system">
            <path value="AllergyIntolerance.reaction.exposureRoute.coding.system" />
            <min value="1" />
            <fixedUri value="http://snomed.info/sct" />
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.version">
            <path value="AllergyIntolerance.reaction.exposureRoute.coding.version" />
            <max value="0" />
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.code">
            <path value="AllergyIntolerance.reaction.exposureRoute.coding.code" />
            <min value="1" />
        </element>
        <element id="AllergyIntolerance.reaction.note.author[x]">
            <path value="AllergyIntolerance.reaction.note.author[x]" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
            </type>
            <type>
                <code value="string" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1" />
            </type>
        </element>
    </differential>
</StructureDefinition>
{
    "resourceType": "StructureDefinition",
    "meta": {
        "lastUpdated": "2018-08-02T12:07:36.924+01:00"
    },
    "extension":  [
        {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
            "valueCode": "pc"
        }
    ],
    "url": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-AllergyIntolerance-1",
    "version": "1.7.0",
    "name": "CareConnect-GPC-AllergyIntolerance-1",
    "status": "active",
    "date": "2020-02-17",
    "publisher": "HL7 UK",
    "description": "This AllergyIntolerance Resource records Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance.",
    "copyright": "Copyright © 2020 HL7 UK\n\nLicensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at\n\nhttp://www.apache.org/licenses/LICENSE-2.0\n\nUnless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License.\n\nHL7® FHIR® standard Copyright © 2011+ HL7\n\nThe HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at\n\nhttps://www.hl7.org/fhir/license.html",
    "fhirVersion": "3.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "AllergyIntolerance",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/AllergyIntolerance",
    "derivation": "constraint",
    "snapshot": {
        "element":  [
            {
                "id": "AllergyIntolerance",
                "path": "AllergyIntolerance",
                "short": "Allergy or Intolerance (generally: Risk of adverse reaction to a substance)",
                "definition": "Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance.",
                "comment": "Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.",
                "alias":  [
                    "Allergy",
                    "Intolerance",
                    "Adverse Reaction"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Resource",
                    "min": 0,
                    "max": "*"
                },
                "constraint":  [
                    {
                        "key": "dom-2",
                        "severity": "error",
                        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
                        "expression": "contained.contained.empty()",
                        "xpath": "not(parent::f:contained and f:contained)"
                    },
                    {
                        "key": "dom-1",
                        "severity": "error",
                        "human": "If the resource is contained in another resource, it SHALL NOT contain any narrative",
                        "expression": "contained.text.empty()",
                        "xpath": "not(parent::f:contained and f:text)"
                    },
                    {
                        "key": "dom-4",
                        "severity": "error",
                        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
                        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
                        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"
                    },
                    {
                        "key": "dom-3",
                        "severity": "error",
                        "human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource",
                        "expression": "contained.where(('#'+id in %resource.descendants().reference).not()).empty()",
                        "xpath": "not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))"
                    },
                    {
                        "key": "ait-1",
                        "severity": "error",
                        "human": "AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.",
                        "expression": "verificationStatus='entered-in-error' or clinicalStatus.exists()",
                        "xpath": "f:verificationStatus/@value='entered-in-error' or exists(f:clinicalStatus)"
                    },
                    {
                        "key": "ait-2",
                        "severity": "error",
                        "human": "AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error",
                        "expression": "verificationStatus!='entered-in-error' or clinicalStatus.empty()",
                        "xpath": "f:verificationStatus/@value!='entered-in-error' or not(exists(f:clinicalStatus))"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "Entity. Role, or Act"
                    },
                    {
                        "identity": "rim",
                        "map": "Observation[classCode=OBS, moodCode=EVN]"
                    },
                    {
                        "identity": "w5",
                        "map": "clinical.general"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.id",
                "path": "AllergyIntolerance.id",
                "short": "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.",
                "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Resource.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "id"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.meta",
                "path": "AllergyIntolerance.meta",
                "short": "Metadata about the resource",
                "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Resource.meta",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Meta"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.meta.id",
                "path": "AllergyIntolerance.meta.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "xml:id (or equivalent in JSON)",
                "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.meta.extension",
                "path": "AllergyIntolerance.meta.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional Content defined by implementations",
                "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.meta.versionId",
                "path": "AllergyIntolerance.meta.versionId",
                "short": "Version specific identifier",
                "definition": "The version specific identifier, as it appears in the version portion of the URL. This values changes when the resource is created, updated, or deleted.",
                "comment": "The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Meta.versionId",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "id"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.meta.lastUpdated",
                "path": "AllergyIntolerance.meta.lastUpdated",
                "short": "When the resource version last changed",
                "definition": "When the resource last changed - e.g. when the version changed.",
                "comment": "This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Meta.lastUpdated",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "instant"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.meta.profile",
                "path": "AllergyIntolerance.meta.profile",
                "short": "Profiles this resource claims to conform to",
                "definition": "A list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url]().",
                "comment": "It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time.  The list of profile URLs is a set.",
                "min": 1,
                "max": "*",
                "base": {
                    "path": "Meta.profile",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.meta.security",
                "path": "AllergyIntolerance.meta.security",
                "short": "Security Labels applied to this resource",
                "definition": "Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.",
                "comment": "The security labels can be updated without changing the stated version of the resource  The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Meta.security",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Coding"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "SecurityLabels"
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
                            "valueBoolean": true
                        }
                    ],
                    "strength": "extensible",
                    "description": "Security Labels from the Healthcare Privacy and Security Classification System.",
                    "valueSetReference": {
                        "reference": "http://hl7.org/fhir/ValueSet/security-labels"
                    }
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
                    },
                    {
                        "identity": "rim",
                        "map": "CV"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.meta.tag",
                "path": "AllergyIntolerance.meta.tag",
                "short": "Tags applied to this resource",
                "definition": "Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.",
                "comment": "The tags can be updated without changing the stated version of the resource.  The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Meta.tag",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Coding"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "Tags"
                        }
                    ],
                    "strength": "example",
                    "description": "Codes that represent various types of tags, commonly workflow-related; e.g. \"Needs review by Dr. Jones\"",
                    "valueSetReference": {
                        "reference": "http://hl7.org/fhir/ValueSet/common-tags"
                    }
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
                    },
                    {
                        "identity": "rim",
                        "map": "CV"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.implicitRules",
                "path": "AllergyIntolerance.implicitRules",
                "short": "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.",
                "comment": "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. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Resource.implicitRules",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isModifier": true,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.language",
                "path": "AllergyIntolerance.language",
                "short": "Language of the resource content",
                "definition": "The base language in which the resource is written.",
                "comment": "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).",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Resource.language",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
                            "valueReference": {
                                "reference": "http://hl7.org/fhir/ValueSet/all-languages"
                            }
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "Language"
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
                            "valueBoolean": true
                        }
                    ],
                    "strength": "extensible",
                    "description": "A human language.",
                    "valueSetReference": {
                        "reference": "http://hl7.org/fhir/ValueSet/languages"
                    }
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.text",
                "path": "AllergyIntolerance.text",
                "short": "Text summary of the resource, for human interpretation",
                "definition": "A human-readable narrative that contains a summary of the resource, and may 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.",
                "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
                "alias":  [
                    "narrative",
                    "html",
                    "xhtml",
                    "display"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "DomainResource.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Narrative"
                    }
                ],
                "condition":  [
                    "ele-1",
                    "dom-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "Act.text?"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.contained",
                "path": "AllergyIntolerance.contained",
                "short": "Contained, inline Resources",
                "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
                "comment": "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.",
                "alias":  [
                    "inline resources",
                    "anonymous resources",
                    "contained resources"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.contained",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Resource"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "Entity. Role, or Act"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.extension",
                "path": "AllergyIntolerance.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional Content defined by implementations",
                "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.extension:encounter",
                "path": "AllergyIntolerance.extension",
                "sliceName": "encounter",
                "short": "An associated encounter reference",
                "definition": "An associated encounter reference.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "DomainResource.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile": "http://hl7.org/fhir/StructureDefinition/encounter-associatedEncounter"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.extension:allergyEnd",
                "path": "AllergyIntolerance.extension",
                "sliceName": "allergyEnd",
                "short": "Supports the date and reason that the allergy was no longer valid",
                "definition": "Supports the date and reason that the allergy was no longer valid.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "DomainResource.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-AllergyIntoleranceEnd-1"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.extension:evidence",
                "path": "AllergyIntolerance.extension",
                "sliceName": "evidence",
                "short": "A reference to results of investigations that confirmed the certainty of the diagnosis",
                "definition": "A reference to results of investigations that confirmed the certainty of the diagnosis.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "DomainResource.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-Evidence-1"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.modifierExtension",
                "path": "AllergyIntolerance.modifierExtension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Extensions that cannot be ignored",
                "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "isModifier": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.identifier",
                "path": "AllergyIntolerance.identifier",
                "short": "External ids for this item",
                "definition": "This records identifiers associated with this allergy/intolerance concern that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).",
                "min": 1,
                "max": "*",
                "base": {
                    "path": "AllergyIntolerance.identifier",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Identifier"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
                    },
                    {
                        "identity": "rim",
                        "map": "II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]"
                    },
                    {
                        "identity": "servd",
                        "map": "Identifier"
                    },
                    {
                        "identity": "v2",
                        "map": "IAM-7"
                    },
                    {
                        "identity": "rim",
                        "map": "id"
                    },
                    {
                        "identity": "w5",
                        "map": "id"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.identifier.id",
                "path": "AllergyIntolerance.identifier.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "xml:id (or equivalent in JSON)",
                "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.identifier.extension",
                "path": "AllergyIntolerance.identifier.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional Content defined by implementations",
                "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.identifier.use",
                "path": "AllergyIntolerance.identifier.use",
                "short": "usual | official | temp | secondary (If known)",
                "definition": "The purpose of this identifier.",
                "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
                "requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Identifier.use",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isModifier": true,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "IdentifierUse"
                        }
                    ],
                    "strength": "required",
                    "description": "Identifies the purpose for this identifier, if known .",
                    "valueSetReference": {
                        "reference": "http://hl7.org/fhir/ValueSet/identifier-use"
                    }
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "Role.code or implied by context"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.identifier.type",
                "path": "AllergyIntolerance.identifier.type",
                "short": "Description of identifier",
                "definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
                "comment": "This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. \n\nWhere the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
                "requirements": "Allows users to make use of identifiers when the identifier system is not known.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Identifier.type",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "IdentifierType"
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
                            "valueBoolean": true
                        }
                    ],
                    "strength": "extensible",
                    "description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
                    "valueSetReference": {
                        "reference": "http://hl7.org/fhir/ValueSet/identifier-type"
                    }
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "v2",
                        "map": "CX.5"
                    },
                    {
                        "identity": "rim",
                        "map": "Role.code or implied by context"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.identifier.system",
                "path": "AllergyIntolerance.identifier.system",
                "short": "The namespace for the identifier value",
                "definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
                "comment": "see http://en.wikipedia.org/wiki/Uniform_resource_identifier",
                "requirements": "There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Identifier.system",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "example":  [
                    {
                        "label": "General",
                        "valueUri": "http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CX.4 / EI-2-4"
                    },
                    {
                        "identity": "rim",
                        "map": "II.root or Role.id.root"
                    },
                    {
                        "identity": "servd",
                        "map": "./IdentifierType"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.identifier.value",
                "path": "AllergyIntolerance.identifier.value",
                "short": "The value that is unique",
                "definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
                "comment": "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html).",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Identifier.value",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "example":  [
                    {
                        "label": "General",
                        "valueString": "123456"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CX.1 / EI.1"
                    },
                    {
                        "identity": "rim",
                        "map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
                    },
                    {
                        "identity": "servd",
                        "map": "./Value"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.identifier.period",
                "path": "AllergyIntolerance.identifier.period",
                "short": "Time period when id is/was valid for use",
                "definition": "Time period during which identifier is/was valid for use.",
                "comment": "This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\"). If duration is required, specify the type as Interval|Duration.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Identifier.period",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Period"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "per-1",
                        "severity": "error",
                        "human": "If present, start SHALL have a lower value than end",
                        "expression": "start.empty() or end.empty() or (start <= end)",
                        "xpath": "not(exists(f:start)) or not(exists(f:end)) or (f:start/@value <= f:end/@value)"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "DR"
                    },
                    {
                        "identity": "rim",
                        "map": "IVL<TS>[lowClosed=\"true\" and highClosed=\"true\"] or URG<TS>[lowClosed=\"true\" and highClosed=\"true\"]"
                    },
                    {
                        "identity": "v2",
                        "map": "CX.7 + CX.8"
                    },
                    {
                        "identity": "rim",
                        "map": "Role.effectiveTime or implied by context"
                    },
                    {
                        "identity": "servd",
                        "map": "./StartDate and ./EndDate"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.identifier.assigner",
                "path": "AllergyIntolerance.identifier.assigner",
                "short": "Organization that issued id (may be just text)",
                "definition": "Organization that issued/manages the identifier.",
                "comment": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Identifier.assigner",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "v2",
                        "map": "CX.4 / (CX.4,CX.9,CX.10)"
                    },
                    {
                        "identity": "rim",
                        "map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"
                    },
                    {
                        "identity": "servd",
                        "map": "./IdentifierIssuingAuthority"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.clinicalStatus",
                "path": "AllergyIntolerance.clinicalStatus",
                "short": "active | inactive | resolved",
                "definition": "The clinical status of the allergy or intolerance.",
                "comment": "This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as not currently valid.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "AllergyIntolerance.clinicalStatus",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "ele-1",
                    "ait-1",
                    "ait-2"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isModifier": true,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "AllergyIntoleranceClinicalStatus"
                        }
                    ],
                    "strength": "required",
                    "description": "The clinical status of the allergy or intolerance.",
                    "valueSetReference": {
                        "reference": "http://hl7.org/fhir/ValueSet/allergy-clinical-status"
                    }
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
                    },
                    {
                        "identity": "w5",
                        "map": "status"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.verificationStatus",
                "path": "AllergyIntolerance.verificationStatus",
                "short": "unconfirmed | confirmed",
                "definition": "Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product).",
                "comment": "This element is labeled as a modifier because the status contains the codes refuted and entered-in-error that mark the AllergyIntolerance as not currently valid.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "AllergyIntolerance.verificationStatus",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "fixedCode": "unconfirmed",
                "condition":  [
                    "ele-1",
                    "ait-1",
                    "ait-2"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isModifier": true,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "AllergyIntoleranceVerificationStatus"
                        }
                    ],
                    "strength": "required",
                    "description": "Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.",
                    "valueSetReference": {
                        "reference": "http://hl7.org/fhir/ValueSet/allergy-verification-status"
                    }
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
                    },
                    {
                        "identity": "w5",
                        "map": "status"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.type",
                "path": "AllergyIntolerance.type",
                "short": "allergy | intolerance - Underlying mechanism (if known)",
                "definition": "Identification of the underlying physiological mechanism for the reaction risk.",
                "comment": "Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term \"allergy\" is used rather generically and may overlap with the use of \"intolerance\" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.",
                "alias":  [
                    "Category",
                    "Class"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "AllergyIntolerance.type",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "AllergyIntoleranceType"
                        }
                    ],
                    "strength": "required",
                    "description": "Identification of the underlying physiological mechanism for a Reaction Risk.",
                    "valueSetReference": {
                        "reference": "http://hl7.org/fhir/ValueSet/allergy-intolerance-type"
                    }
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "IAM-9"
                    },
                    {
                        "identity": "rim",
                        "map": "code"
                    },
                    {
                        "identity": "w5",
                        "map": "class"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.category",
                "path": "AllergyIntolerance.category",
                "short": "food | medication | environment | biologic",
                "definition": "Category of the identified substance.",
                "comment": "This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation.  When searching on category, consider the implications of AllergyIntolerance resources without a category.  For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned.  Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category.  Additionally, category should be used with caution because category can be subjective based on the sender.",
                "alias":  [
                    "Category",
                    "Type",
                    "Reaction Type",
                    "Class"
                ],
                "min": 1,
                "max": "*",
                "base": {
                    "path": "AllergyIntolerance.category",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "AllergyIntoleranceCategory"
                        }
                    ],
                    "strength": "required",
                    "description": "Category of an identified substance.",
                    "valueSetReference": {
                        "reference": "http://hl7.org/fhir/ValueSet/allergy-intolerance-category"
                    }
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "AL1-2"
                    },
                    {
                        "identity": "rim",
                        "map": "value < IntoleranceValue (Agent)"
                    },
                    {
                        "identity": "w5",
                        "map": "class"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.criticality",
                "path": "AllergyIntolerance.criticality",
                "short": "low | high | unable-to-assess",
                "definition": "Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.",
                "comment": "The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).\n\nSystems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity.  Existing systems that are capturing both condition criticality and reaction severity may use the term \"severity\" to represent both.  Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent.",
                "alias":  [
                    "Severity",
                    "Seriousness",
                    "Contra-indication",
                    "Risk"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "AllergyIntolerance.criticality",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "AllergyIntoleranceCriticality"
                        }
                    ],
                    "strength": "required",
                    "description": "Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.",
                    "valueSetReference": {
                        "reference": "http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality"
                    }
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "AL1-4"
                    },
                    {
                        "identity": "rim",
                        "map": "inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)]"
                    },
                    {
                        "identity": "w5",
                        "map": "grade"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.code",
                "path": "AllergyIntolerance.code",
                "short": "Code that identifies the allergy or intolerance",
                "definition": "Code for an allergy or intolerance statement (either a positive or a negated/excluded statement).  This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., \"Latex\"), an allergy or intolerance condition (e.g., \"Latex allergy\"), or a negated/excluded code for a specific substance or class (e.g., \"No latex allergy\") or a general or categorical negated statement (e.g.,  \"No known allergy\", \"No known drug allergies\").",
                "comment": "It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.\n\nWhen a substance or product code is specified for the 'code' element, the \"default\" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product.  In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the \"Causative agent\" relationship.\n\nThe 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements.  This extension provides the capability to make \"no known allergy\" (or \"no risk of adverse reaction\") statements regarding any coded substance/product (including cases when a pre-coordinated \"no allergy to x\" concept for that substance/product does not exist).  If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.",
                "alias":  [
                    "Code"
                ],
                "min": 1,
                "max": "1",
                "base": {
                    "path": "AllergyIntolerance.code",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "AllergyIntoleranceCode"
                        }
                    ],
                    "strength": "example",
                    "description": "Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies.",
                    "valueSetReference": {
                        "reference": "https://fhir.nhs.uk/STU3/ValueSet/CareConnect-AllergyCode-1"
                    }
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "v2",
                        "map": "AL1-3 / IAM-3"
                    },
                    {
                        "identity": "rim",
                        "map": "substance/product:\n\n.participation[typeCode=CAGNT].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType]\n\nnegated/excluded substance/product:\n\n.participation[typeCode=CAGNT, negationInd=true].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType]\n\npositive or negated/excluded condition/situation:\n\nObservation.code=ASSERTION; Observation.value"
                    },
                    {
                        "identity": "w5",
                        "map": "what"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.code.id",
                "path": "AllergyIntolerance.code.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "xml:id (or equivalent in JSON)",
                "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.code.extension",
                "path": "AllergyIntolerance.code.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional Content defined by implementations",
                "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.code.coding",
                "path": "AllergyIntolerance.code.coding",
                "short": "Code defined by a terminology system",
                "definition": "A reference to a code defined by a terminology system.",
                "comment": "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.",
                "requirements": "Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "CodeableConcept.coding",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Coding"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
                    },
                    {
                        "identity": "rim",
                        "map": "CV"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.1-8, C*E.10-22"
                    },
                    {
                        "identity": "rim",
                        "map": "union(., ./translation)"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.code.coding.id",
                "path": "AllergyIntolerance.code.coding.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "xml:id (or equivalent in JSON)",
                "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.code.coding.extension",
                "path": "AllergyIntolerance.code.coding.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional Content defined by implementations",
                "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.code.coding.extension:snomedCTDescriptionID",
                "path": "AllergyIntolerance.code.coding.extension",
                "sliceName": "snomedCTDescriptionID",
                "short": "The SNOMED CT Description ID for the display",
                "definition": "The SNOMED CT Description ID for the display.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.code.coding.system",
                "path": "AllergyIntolerance.code.coding.system",
                "short": "Identity of the terminology system",
                "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
                "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.",
                "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Coding.system",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.3"
                    },
                    {
                        "identity": "rim",
                        "map": "./codeSystem"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.code.coding.version",
                "path": "AllergyIntolerance.code.coding.version",
                "short": "Version of the system - if relevant",
                "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
                "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Coding.version",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.7"
                    },
                    {
                        "identity": "rim",
                        "map": "./codeSystemVersion"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.code.coding.code",
                "path": "AllergyIntolerance.code.coding.code",
                "short": "Symbol in syntax defined by the system",
                "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "requirements": "Need to refer to a particular code in the system.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Coding.code",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.1"
                    },
                    {
                        "identity": "rim",
                        "map": "./code"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.code.coding.display",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "AllergyIntolerance.code.coding.display",
                "short": "Representation defined by the system",
                "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.display",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.2 - but note this is not well followed"
                    },
                    {
                        "identity": "rim",
                        "map": "CV.displayName"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.code.coding.userSelected",
                "path": "AllergyIntolerance.code.coding.userSelected",
                "short": "If this coding was chosen directly by the user",
                "definition": "Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).",
                "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
                "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.userSelected",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "Sometimes implied by being first"
                    },
                    {
                        "identity": "rim",
                        "map": "CD.codingRationale"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.code.text",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "AllergyIntolerance.code.text",
                "short": "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.",
                "comment": "Very often the text is the same as a displayName of one of the codings.",
                "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "CodeableConcept.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.9. But note many systems use C*E.2 for this"
                    },
                    {
                        "identity": "rim",
                        "map": "./originalText[mediaType/code=\"text/plain\"]/data"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.patient",
                "path": "AllergyIntolerance.patient",
                "short": "Who the sensitivity is for",
                "definition": "The patient who has the allergy or intolerance.",
                "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
                "alias":  [
                    "Patient"
                ],
                "min": 1,
                "max": "1",
                "base": {
                    "path": "AllergyIntolerance.patient",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "v2",
                        "map": "(PID-3)"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=SBJ].role[classCode=PAT]"
                    },
                    {
                        "identity": "w5",
                        "map": "who.focus"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.onset[x]",
                "path": "AllergyIntolerance.onset[x]",
                "short": "When allergy or intolerance was identified",
                "definition": "Estimated or actual date,  date-time, or age when allergy or intolerance was identified.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "AllergyIntolerance.onset[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    },
                    {
                        "code": "Age"
                    },
                    {
                        "code": "Period"
                    },
                    {
                        "code": "Range"
                    },
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "effectiveTime.low"
                    },
                    {
                        "identity": "w5",
                        "map": "when.init"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.assertedDate",
                "path": "AllergyIntolerance.assertedDate",
                "short": "Date record was believed accurate",
                "definition": "The date on which the existance of the AllergyIntolerance was first asserted or acknowledged.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "AllergyIntolerance.assertedDate",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "IAM-20"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=AUT].time"
                    },
                    {
                        "identity": "w5",
                        "map": "when.recorded"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.recorder",
                "path": "AllergyIntolerance.recorder",
                "short": "Who recorded the sensitivity",
                "definition": "Individual who recorded the record and takes responsibility for its content.",
                "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
                "alias":  [
                    "Author"
                ],
                "min": 1,
                "max": "1",
                "base": {
                    "path": "AllergyIntolerance.recorder",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
                    },
                    {
                        "code": "Reference",
                        "targetProfile": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=AUT].role"
                    },
                    {
                        "identity": "w5",
                        "map": "who.author"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.asserter",
                "path": "AllergyIntolerance.asserter",
                "short": "Source of the information about the allergy",
                "definition": "The source of the information about the allergy that is recorded.",
                "comment": "The recorder takes repsonsibility for the content, but can reference the source from where they got it.",
                "alias":  [
                    "Source",
                    "Informant"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "AllergyIntolerance.asserter",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
                    },
                    {
                        "code": "Reference",
                        "targetProfile": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
                    },
                    {
                        "code": "Reference",
                        "targetProfile": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"
                    }
                ],
                "mustSupport": true,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "v2",
                        "map": "IAM-14 (if patient) / IAM-18 (if practitioner)"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=INF].role"
                    },
                    {
                        "identity": "w5",
                        "map": "who.source"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.lastOccurrence",
                "path": "AllergyIntolerance.lastOccurrence",
                "short": "Date(/time) of last known occurrence of a reaction",
                "definition": "Represents the date and/or time of the last known occurrence of a reaction event.",
                "comment": "This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "AllergyIntolerance.lastOccurrence",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)].effectiveTime"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.note",
                "path": "AllergyIntolerance.note",
                "short": "Additional text not captured in other fields",
                "definition": "Additional narrative about the propensity for the Adverse Reaction, not captured in other fields.",
                "comment": "For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and  AllergyIntolerance.event.notes.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "AllergyIntolerance.note",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Annotation"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "Act"
                    },
                    {
                        "identity": "rim",
                        "map": "subjectOf.observationEvent[code=\"annotation\"].value"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.note.id",
                "path": "AllergyIntolerance.note.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "xml:id (or equivalent in JSON)",
                "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.note.extension",
                "path": "AllergyIntolerance.note.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional Content defined by implementations",
                "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.note.author[x]",
                "path": "AllergyIntolerance.note.author[x]",
                "short": "Individual responsible for the annotation",
                "definition": "The individual responsible for making the annotation.",
                "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Annotation.author[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
                    },
                    {
                        "code": "string"
                    },
                    {
                        "code": "Reference",
                        "targetProfile": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
                    },
                    {
                        "code": "Reference",
                        "targetProfile": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "v2",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "Act.participant[typeCode=AUT].role"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.note.time",
                "path": "AllergyIntolerance.note.time",
                "short": "When the annotation was made",
                "definition": "Indicates when this particular annotation was made.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Annotation.time",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "Act.effectiveTime"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.note.text",
                "path": "AllergyIntolerance.note.text",
                "short": "The annotation  - text content",
                "definition": "The text of the annotation.",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Annotation.text",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "Act.text"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction",
                "path": "AllergyIntolerance.reaction",
                "short": "Adverse Reaction Events linked to exposure to substance",
                "definition": "Details about each adverse reaction event linked to exposure to the identified substance.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "AllergyIntolerance.reaction",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "BackboneElement"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)]"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.id",
                "path": "AllergyIntolerance.reaction.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "xml:id (or equivalent in JSON)",
                "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.extension",
                "path": "AllergyIntolerance.reaction.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional Content defined by implementations",
                "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.modifierExtension",
                "path": "AllergyIntolerance.reaction.modifierExtension",
                "short": "Extensions that cannot be ignored",
                "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 that contains it. Usually modifier elements provide negation or qualification. In order 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content",
                    "modifiers"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "BackboneElement.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "isModifier": true,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.substance",
                "path": "AllergyIntolerance.reaction.substance",
                "short": "Specific substance or pharmaceutical product considered to be responsible for event",
                "definition": "Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'.",
                "comment": "Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible.  The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, \"penicillins\"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, \"amoxycillin\"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "AllergyIntolerance.reaction.substance",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "SubstanceCode"
                        }
                    ],
                    "strength": "example",
                    "description": "Codes defining the type of the substance (including pharmaceutical products).",
                    "valueSetReference": {
                        "reference": "http://hl7.org/fhir/ValueSet/substance-code"
                    }
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "rim",
                        "map": "outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].participation[typeCode=CSM].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType]"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.substance.id",
                "path": "AllergyIntolerance.reaction.substance.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "xml:id (or equivalent in JSON)",
                "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.substance.extension",
                "path": "AllergyIntolerance.reaction.substance.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional Content defined by implementations",
                "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.substance.coding",
                "path": "AllergyIntolerance.reaction.substance.coding",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "system"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                },
                "short": "Code defined by a terminology system",
                "definition": "A reference to a code defined by a terminology system.",
                "comment": "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.",
                "requirements": "Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "CodeableConcept.coding",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Coding"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
                    },
                    {
                        "identity": "rim",
                        "map": "CV"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.1-8, C*E.10-22"
                    },
                    {
                        "identity": "rim",
                        "map": "union(., ./translation)"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.substance.coding:snomedCT",
                "path": "AllergyIntolerance.reaction.substance.coding",
                "sliceName": "snomedCT",
                "short": "Code defined by a terminology system",
                "definition": "A reference to a code defined by a terminology system.",
                "comment": "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.",
                "requirements": "Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "CodeableConcept.coding",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Coding"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
                    },
                    {
                        "identity": "rim",
                        "map": "CV"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.1-8, C*E.10-22"
                    },
                    {
                        "identity": "rim",
                        "map": "union(., ./translation)"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.substance.coding:snomedCT.id",
                "path": "AllergyIntolerance.reaction.substance.coding.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "xml:id (or equivalent in JSON)",
                "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.substance.coding:snomedCT.extension",
                "path": "AllergyIntolerance.reaction.substance.coding.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional Content defined by implementations",
                "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID",
                "path": "AllergyIntolerance.reaction.substance.coding.extension",
                "sliceName": "snomedCTDescriptionID",
                "short": "The SNOMED CT Description ID for the display",
                "definition": "The SNOMED CT Description ID for the display.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.substance.coding:snomedCT.system",
                "path": "AllergyIntolerance.reaction.substance.coding.system",
                "short": "Identity of the terminology system",
                "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
                "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.",
                "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Coding.system",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "fixedUri": "http://snomed.info/sct",
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.3"
                    },
                    {
                        "identity": "rim",
                        "map": "./codeSystem"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.substance.coding:snomedCT.version",
                "path": "AllergyIntolerance.reaction.substance.coding.version",
                "short": "Version of the system - if relevant",
                "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
                "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Coding.version",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.7"
                    },
                    {
                        "identity": "rim",
                        "map": "./codeSystemVersion"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.substance.coding:snomedCT.code",
                "path": "AllergyIntolerance.reaction.substance.coding.code",
                "short": "Symbol in syntax defined by the system",
                "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "requirements": "Need to refer to a particular code in the system.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Coding.code",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.1"
                    },
                    {
                        "identity": "rim",
                        "map": "./code"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.substance.coding:snomedCT.display",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "AllergyIntolerance.reaction.substance.coding.display",
                "short": "Representation defined by the system",
                "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.display",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.2 - but note this is not well followed"
                    },
                    {
                        "identity": "rim",
                        "map": "CV.displayName"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.substance.coding:snomedCT.userSelected",
                "path": "AllergyIntolerance.reaction.substance.coding.userSelected",
                "short": "If this coding was chosen directly by the user",
                "definition": "Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).",
                "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
                "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.userSelected",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "Sometimes implied by being first"
                    },
                    {
                        "identity": "rim",
                        "map": "CD.codingRationale"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.substance.text",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "AllergyIntolerance.reaction.substance.text",
                "short": "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.",
                "comment": "Very often the text is the same as a displayName of one of the codings.",
                "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "CodeableConcept.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.9. But note many systems use C*E.2 for this"
                    },
                    {
                        "identity": "rim",
                        "map": "./originalText[mediaType/code=\"text/plain\"]/data"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation",
                "path": "AllergyIntolerance.reaction.manifestation",
                "short": "Clinical symptoms/signs associated with the Event",
                "definition": "Clinical symptoms and/or signs that are observed or associated with the adverse reaction event.",
                "comment": "Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.  Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.",
                "alias":  [
                    "Symptoms",
                    "Signs"
                ],
                "min": 1,
                "max": "*",
                "base": {
                    "path": "AllergyIntolerance.reaction.manifestation",
                    "min": 1,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "Manifestation"
                        }
                    ],
                    "strength": "extensible",
                    "description": "Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.",
                    "valueSetReference": {
                        "reference": "https://fhir.hl7.org.uk/STU3/ValueSet/CareConnect-AllergyManifestation-1"
                    }
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "v2",
                        "map": "AL1-5"
                    },
                    {
                        "identity": "rim",
                        "map": "code"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.id",
                "path": "AllergyIntolerance.reaction.manifestation.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "xml:id (or equivalent in JSON)",
                "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.extension",
                "path": "AllergyIntolerance.reaction.manifestation.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional Content defined by implementations",
                "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.coding",
                "path": "AllergyIntolerance.reaction.manifestation.coding",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "system"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                },
                "short": "Code defined by a terminology system",
                "definition": "A reference to a code defined by a terminology system.",
                "comment": "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.",
                "requirements": "Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "CodeableConcept.coding",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Coding"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
                    },
                    {
                        "identity": "rim",
                        "map": "CV"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.1-8, C*E.10-22"
                    },
                    {
                        "identity": "rim",
                        "map": "union(., ./translation)"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT",
                "path": "AllergyIntolerance.reaction.manifestation.coding",
                "sliceName": "snomedCT",
                "short": "Code defined by a terminology system",
                "definition": "A reference to a code defined by a terminology system.",
                "comment": "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.",
                "requirements": "Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "CodeableConcept.coding",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Coding"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
                    },
                    {
                        "identity": "rim",
                        "map": "CV"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.1-8, C*E.10-22"
                    },
                    {
                        "identity": "rim",
                        "map": "union(., ./translation)"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT.id",
                "path": "AllergyIntolerance.reaction.manifestation.coding.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "xml:id (or equivalent in JSON)",
                "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension",
                "path": "AllergyIntolerance.reaction.manifestation.coding.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional Content defined by implementations",
                "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID",
                "path": "AllergyIntolerance.reaction.manifestation.coding.extension",
                "sliceName": "snomedCTDescriptionID",
                "short": "The SNOMED CT Description ID for the display",
                "definition": "The SNOMED CT Description ID for the display.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT.system",
                "path": "AllergyIntolerance.reaction.manifestation.coding.system",
                "short": "Identity of the terminology system",
                "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
                "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.",
                "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Coding.system",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "fixedUri": "http://snomed.info/sct",
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.3"
                    },
                    {
                        "identity": "rim",
                        "map": "./codeSystem"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT.version",
                "path": "AllergyIntolerance.reaction.manifestation.coding.version",
                "short": "Version of the system - if relevant",
                "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
                "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Coding.version",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.7"
                    },
                    {
                        "identity": "rim",
                        "map": "./codeSystemVersion"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT.code",
                "path": "AllergyIntolerance.reaction.manifestation.coding.code",
                "short": "Symbol in syntax defined by the system",
                "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "requirements": "Need to refer to a particular code in the system.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Coding.code",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.1"
                    },
                    {
                        "identity": "rim",
                        "map": "./code"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT.display",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "AllergyIntolerance.reaction.manifestation.coding.display",
                "short": "Representation defined by the system",
                "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.display",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.2 - but note this is not well followed"
                    },
                    {
                        "identity": "rim",
                        "map": "CV.displayName"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT.userSelected",
                "path": "AllergyIntolerance.reaction.manifestation.coding.userSelected",
                "short": "If this coding was chosen directly by the user",
                "definition": "Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).",
                "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
                "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.userSelected",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "Sometimes implied by being first"
                    },
                    {
                        "identity": "rim",
                        "map": "CD.codingRationale"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.text",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "AllergyIntolerance.reaction.manifestation.text",
                "short": "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.",
                "comment": "Very often the text is the same as a displayName of one of the codings.",
                "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "CodeableConcept.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.9. But note many systems use C*E.2 for this"
                    },
                    {
                        "identity": "rim",
                        "map": "./originalText[mediaType/code=\"text/plain\"]/data"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.description",
                "path": "AllergyIntolerance.reaction.description",
                "short": "Description of the event as a whole",
                "definition": "Text description about the reaction as a whole, including details of the manifestation if required.",
                "comment": "Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.",
                "alias":  [
                    "Narrative",
                    "Text"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "AllergyIntolerance.reaction.description",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "text"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.onset",
                "path": "AllergyIntolerance.reaction.onset",
                "short": "Date(/time) when manifestations showed",
                "definition": "Record of the date and/or time of the onset of the Reaction.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "AllergyIntolerance.reaction.onset",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "AL1-6"
                    },
                    {
                        "identity": "rim",
                        "map": "effectiveTime.low"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.severity",
                "path": "AllergyIntolerance.reaction.severity",
                "short": "mild | moderate | severe (of event as a whole)",
                "definition": "Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations.",
                "comment": "It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "AllergyIntolerance.reaction.severity",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mustSupport": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "AllergyIntoleranceSeverity"
                        }
                    ],
                    "strength": "required",
                    "description": "Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.",
                    "valueSetReference": {
                        "reference": "http://hl7.org/fhir/ValueSet/reaction-event-severity"
                    }
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)]"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute",
                "path": "AllergyIntolerance.reaction.exposureRoute",
                "short": "How the subject was exposed to the substance",
                "definition": "Identification of the route by which the subject was exposed to the substance.",
                "comment": "Coding of the route of exposure with a terminology should be used wherever possible.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "AllergyIntolerance.reaction.exposureRoute",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "RouteOfAdministration"
                        }
                    ],
                    "strength": "example",
                    "description": "A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.",
                    "valueSetReference": {
                        "reference": "https://fhir.nhs.uk/STU3/ValueSet/CareConnect-AllergyExposureRoute-1"
                    }
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "rim",
                        "map": "outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].routeCode"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.id",
                "path": "AllergyIntolerance.reaction.exposureRoute.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "xml:id (or equivalent in JSON)",
                "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.extension",
                "path": "AllergyIntolerance.reaction.exposureRoute.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional Content defined by implementations",
                "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.coding",
                "path": "AllergyIntolerance.reaction.exposureRoute.coding",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "system"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                },
                "short": "Code defined by a terminology system",
                "definition": "A reference to a code defined by a terminology system.",
                "comment": "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.",
                "requirements": "Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "CodeableConcept.coding",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Coding"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
                    },
                    {
                        "identity": "rim",
                        "map": "CV"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.1-8, C*E.10-22"
                    },
                    {
                        "identity": "rim",
                        "map": "union(., ./translation)"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT",
                "path": "AllergyIntolerance.reaction.exposureRoute.coding",
                "sliceName": "snomedCT",
                "short": "Code defined by a terminology system",
                "definition": "A reference to a code defined by a terminology system.",
                "comment": "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.",
                "requirements": "Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "CodeableConcept.coding",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Coding"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
                    },
                    {
                        "identity": "rim",
                        "map": "CV"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.1-8, C*E.10-22"
                    },
                    {
                        "identity": "rim",
                        "map": "union(., ./translation)"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.id",
                "path": "AllergyIntolerance.reaction.exposureRoute.coding.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "xml:id (or equivalent in JSON)",
                "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension",
                "path": "AllergyIntolerance.reaction.exposureRoute.coding.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional Content defined by implementations",
                "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID",
                "path": "AllergyIntolerance.reaction.exposureRoute.coding.extension",
                "sliceName": "snomedCTDescriptionID",
                "short": "The SNOMED CT Description ID for the display",
                "definition": "The SNOMED CT Description ID for the display.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.system",
                "path": "AllergyIntolerance.reaction.exposureRoute.coding.system",
                "short": "Identity of the terminology system",
                "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
                "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.",
                "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Coding.system",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "fixedUri": "http://snomed.info/sct",
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.3"
                    },
                    {
                        "identity": "rim",
                        "map": "./codeSystem"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.version",
                "path": "AllergyIntolerance.reaction.exposureRoute.coding.version",
                "short": "Version of the system - if relevant",
                "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
                "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Coding.version",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.7"
                    },
                    {
                        "identity": "rim",
                        "map": "./codeSystemVersion"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.code",
                "path": "AllergyIntolerance.reaction.exposureRoute.coding.code",
                "short": "Symbol in syntax defined by the system",
                "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "requirements": "Need to refer to a particular code in the system.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Coding.code",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.1"
                    },
                    {
                        "identity": "rim",
                        "map": "./code"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.display",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "AllergyIntolerance.reaction.exposureRoute.coding.display",
                "short": "Representation defined by the system",
                "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.display",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.2 - but note this is not well followed"
                    },
                    {
                        "identity": "rim",
                        "map": "CV.displayName"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.userSelected",
                "path": "AllergyIntolerance.reaction.exposureRoute.coding.userSelected",
                "short": "If this coding was chosen directly by the user",
                "definition": "Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).",
                "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
                "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.userSelected",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "Sometimes implied by being first"
                    },
                    {
                        "identity": "rim",
                        "map": "CD.codingRationale"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.text",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "AllergyIntolerance.reaction.exposureRoute.text",
                "short": "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.",
                "comment": "Very often the text is the same as a displayName of one of the codings.",
                "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "CodeableConcept.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.9. But note many systems use C*E.2 for this"
                    },
                    {
                        "identity": "rim",
                        "map": "./originalText[mediaType/code=\"text/plain\"]/data"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.note",
                "path": "AllergyIntolerance.reaction.note",
                "short": "Text about event not captured in other fields",
                "definition": "Additional text about the adverse reaction event not captured in other fields.",
                "comment": "Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "AllergyIntolerance.reaction.note",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Annotation"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "Act"
                    },
                    {
                        "identity": "rim",
                        "map": "subjectOf.observationEvent[code=\"annotation\"].value"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.note.id",
                "path": "AllergyIntolerance.reaction.note.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "xml:id (or equivalent in JSON)",
                "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.note.extension",
                "path": "AllergyIntolerance.reaction.note.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional Content defined by implementations",
                "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.note.author[x]",
                "path": "AllergyIntolerance.reaction.note.author[x]",
                "short": "Individual responsible for the annotation",
                "definition": "The individual responsible for making the annotation.",
                "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Annotation.author[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
                    },
                    {
                        "code": "string"
                    },
                    {
                        "code": "Reference",
                        "targetProfile": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
                    },
                    {
                        "code": "Reference",
                        "targetProfile": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "v2",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "Act.participant[typeCode=AUT].role"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.note.time",
                "path": "AllergyIntolerance.reaction.note.time",
                "short": "When the annotation was made",
                "definition": "Indicates when this particular annotation was made.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Annotation.time",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "Act.effectiveTime"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.note.text",
                "path": "AllergyIntolerance.reaction.note.text",
                "short": "The annotation  - text content",
                "definition": "The text of the annotation.",
                "comment": "Note that FHIR strings may not exceed 1MB in size",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Annotation.text",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() | (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "Act.text"
                    }
                ]
            }
        ]
    },
    "differential": {
        "element":  [
            {
                "id": "AllergyIntolerance.meta.profile",
                "path": "AllergyIntolerance.meta.profile",
                "min": 1
            },
            {
                "id": "AllergyIntolerance.extension",
                "path": "AllergyIntolerance.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "rules": "open"
                }
            },
            {
                "id": "AllergyIntolerance.extension:encounter",
                "path": "AllergyIntolerance.extension",
                "sliceName": "encounter",
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile": "http://hl7.org/fhir/StructureDefinition/encounter-associatedEncounter"
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "AllergyIntolerance.extension:allergyEnd",
                "path": "AllergyIntolerance.extension",
                "sliceName": "allergyEnd",
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-AllergyIntoleranceEnd-1"
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "AllergyIntolerance.extension:evidence",
                "path": "AllergyIntolerance.extension",
                "sliceName": "evidence",
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-Evidence-1"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.identifier",
                "path": "AllergyIntolerance.identifier",
                "min": 1
            },
            {
                "id": "AllergyIntolerance.identifier.system",
                "path": "AllergyIntolerance.identifier.system",
                "min": 1
            },
            {
                "id": "AllergyIntolerance.identifier.value",
                "path": "AllergyIntolerance.identifier.value",
                "min": 1
            },
            {
                "id": "AllergyIntolerance.clinicalStatus",
                "path": "AllergyIntolerance.clinicalStatus",
                "min": 1
            },
            {
                "id": "AllergyIntolerance.verificationStatus",
                "path": "AllergyIntolerance.verificationStatus",
                "short": "unconfirmed | confirmed",
                "fixedCode": "unconfirmed"
            },
            {
                "id": "AllergyIntolerance.category",
                "path": "AllergyIntolerance.category",
                "min": 1
            },
            {
                "id": "AllergyIntolerance.code",
                "path": "AllergyIntolerance.code",
                "min": 1,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "AllergyIntoleranceCode"
                        }
                    ],
                    "strength": "example",
                    "valueSetReference": {
                        "reference": "https://fhir.nhs.uk/STU3/ValueSet/CareConnect-AllergyCode-1"
                    }
                }
            },
            {
                "id": "AllergyIntolerance.code.coding.extension",
                "path": "AllergyIntolerance.code.coding.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "rules": "open"
                }
            },
            {
                "id": "AllergyIntolerance.code.coding.extension:snomedCTDescriptionID",
                "path": "AllergyIntolerance.code.coding.extension",
                "sliceName": "snomedCTDescriptionID",
                "type":  [
                    {
                        "code": "Extension",
                        "profile": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.code.coding.system",
                "path": "AllergyIntolerance.code.coding.system",
                "min": 1
            },
            {
                "id": "AllergyIntolerance.code.coding.version",
                "path": "AllergyIntolerance.code.coding.version",
                "max": "0"
            },
            {
                "id": "AllergyIntolerance.code.coding.code",
                "path": "AllergyIntolerance.code.coding.code",
                "min": 1
            },
            {
                "id": "AllergyIntolerance.patient",
                "path": "AllergyIntolerance.patient",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.onset[x]",
                "path": "AllergyIntolerance.onset[x]",
                "mustSupport": true
            },
            {
                "id": "AllergyIntolerance.assertedDate",
                "path": "AllergyIntolerance.assertedDate",
                "min": 1
            },
            {
                "id": "AllergyIntolerance.recorder",
                "path": "AllergyIntolerance.recorder",
                "min": 1,
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
                    },
                    {
                        "code": "Reference",
                        "targetProfile": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.asserter",
                "path": "AllergyIntolerance.asserter",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
                    },
                    {
                        "code": "Reference",
                        "targetProfile": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
                    },
                    {
                        "code": "Reference",
                        "targetProfile": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1"
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "AllergyIntolerance.note",
                "path": "AllergyIntolerance.note",
                "mustSupport": true
            },
            {
                "id": "AllergyIntolerance.note.author[x]",
                "path": "AllergyIntolerance.note.author[x]",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
                    },
                    {
                        "code": "string"
                    },
                    {
                        "code": "Reference",
                        "targetProfile": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
                    },
                    {
                        "code": "Reference",
                        "targetProfile": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.substance.coding",
                "path": "AllergyIntolerance.reaction.substance.coding",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "system"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                }
            },
            {
                "id": "AllergyIntolerance.reaction.substance.coding:snomedCT",
                "path": "AllergyIntolerance.reaction.substance.coding",
                "sliceName": "snomedCT",
                "max": "1"
            },
            {
                "id": "AllergyIntolerance.reaction.substance.coding:snomedCT.extension",
                "path": "AllergyIntolerance.reaction.substance.coding.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "rules": "open"
                }
            },
            {
                "id": "AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID",
                "path": "AllergyIntolerance.reaction.substance.coding.extension",
                "sliceName": "snomedCTDescriptionID",
                "type":  [
                    {
                        "code": "Extension",
                        "profile": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.substance.coding:snomedCT.system",
                "path": "AllergyIntolerance.reaction.substance.coding.system",
                "min": 1,
                "fixedUri": "http://snomed.info/sct"
            },
            {
                "id": "AllergyIntolerance.reaction.substance.coding:snomedCT.version",
                "path": "AllergyIntolerance.reaction.substance.coding.version",
                "max": "0"
            },
            {
                "id": "AllergyIntolerance.reaction.substance.coding:snomedCT.code",
                "path": "AllergyIntolerance.reaction.substance.coding.code",
                "min": 1
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation",
                "path": "AllergyIntolerance.reaction.manifestation",
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "Manifestation"
                        }
                    ],
                    "strength": "extensible",
                    "valueSetReference": {
                        "reference": "https://fhir.hl7.org.uk/STU3/ValueSet/CareConnect-AllergyManifestation-1"
                    }
                }
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.coding",
                "path": "AllergyIntolerance.reaction.manifestation.coding",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "system"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                }
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT",
                "path": "AllergyIntolerance.reaction.manifestation.coding",
                "sliceName": "snomedCT",
                "max": "1"
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension",
                "path": "AllergyIntolerance.reaction.manifestation.coding.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "rules": "open"
                }
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID",
                "path": "AllergyIntolerance.reaction.manifestation.coding.extension",
                "sliceName": "snomedCTDescriptionID",
                "type":  [
                    {
                        "code": "Extension",
                        "profile": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT.system",
                "path": "AllergyIntolerance.reaction.manifestation.coding.system",
                "min": 1,
                "fixedUri": "http://snomed.info/sct"
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT.version",
                "path": "AllergyIntolerance.reaction.manifestation.coding.version",
                "max": "0"
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT.code",
                "path": "AllergyIntolerance.reaction.manifestation.coding.code",
                "min": 1
            },
            {
                "id": "AllergyIntolerance.reaction.severity",
                "path": "AllergyIntolerance.reaction.severity",
                "mustSupport": true
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute",
                "path": "AllergyIntolerance.reaction.exposureRoute",
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "RouteOfAdministration"
                        }
                    ],
                    "strength": "example",
                    "valueSetReference": {
                        "reference": "https://fhir.nhs.uk/STU3/ValueSet/CareConnect-AllergyExposureRoute-1"
                    }
                }
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.coding",
                "path": "AllergyIntolerance.reaction.exposureRoute.coding",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "system"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                }
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT",
                "path": "AllergyIntolerance.reaction.exposureRoute.coding",
                "sliceName": "snomedCT",
                "max": "1"
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension",
                "path": "AllergyIntolerance.reaction.exposureRoute.coding.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "rules": "open"
                }
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID",
                "path": "AllergyIntolerance.reaction.exposureRoute.coding.extension",
                "sliceName": "snomedCTDescriptionID",
                "type":  [
                    {
                        "code": "Extension",
                        "profile": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.system",
                "path": "AllergyIntolerance.reaction.exposureRoute.coding.system",
                "min": 1,
                "fixedUri": "http://snomed.info/sct"
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.version",
                "path": "AllergyIntolerance.reaction.exposureRoute.coding.version",
                "max": "0"
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.code",
                "path": "AllergyIntolerance.reaction.exposureRoute.coding.code",
                "min": 1
            },
            {
                "id": "AllergyIntolerance.reaction.note.author[x]",
                "path": "AllergyIntolerance.reaction.note.author[x]",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
                    },
                    {
                        "code": "string"
                    },
                    {
                        "code": "Reference",
                        "targetProfile": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
                    },
                    {
                        "code": "Reference",
                        "targetProfile": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1"
                    }
                ]
            }
        ]
    }
}


Data model element usage

Element Use CareConnect (STU3) UK Core (R4)
id
meta.versionId
meta.lastUpdated
meta.profile
meta.security
meta.tag
extension(encounter)
extension(allergyEnd)
extension(evidence)
identifier
clinicalStatus
verificationStatus
type
category
criticality
code
patient
onset.onsetDateTime
assertedDate
recorder
asserter
lastOccurrence
note
reaction.substance
reaction.manifestation
reaction.description
reaction.onset[x]
reaction.severity
reaction.exposureRoute
reaction.note

id

Usage

Optional

Guidance

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

Example
<id value="4095fcc9-c0ae-4f05-b5db-1fb648fe7bda" />


meta.versionId

Usage

Optional

Guidance

The population of the meta.versionId element could be useful if sending an adendum of something previously sent to help the consumer (receiver) in understanding there is a "newer" version.

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


meta.lastUpdated

Usage

Optional

Guidance

The meta.lastUpdated element could be useful alongside the meta.versionId if sending an adendum of something previously sent to help the consumer (receiver) in understanding there is a more recent version.

Example
<meta>
    <lastUpdated value="2022-10-28T08:06:00+00:00" />
</meta>


meta.profile

Usage

Mandatory

Guidance

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

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


meta.security

Usage

Optional

Guidance

The security label(s) applicable to the resource.

See Resources not to be disclosed to a patient for more details on how to populate the element.

Example
<meta>
    <security>
        <system value="http://hl7.org/fhir/v3/ActCode"/>
        <code value="NOPAT"/>
        <display value="no disclosure to patient, family or caregivers without attending provider's authorization"/>
    </security>
</meta>


meta.tag

Usage

Optional

Guidance

A use-case for the meta.tag element within GP Connect has not been defined.

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


extension(encounter)

Usage

Required

Guidance
Note: The encounter is part of the base resource in FHIR R4 / UK CORE.

Providing it is known, the extension.encounter should be populated with a reference to the consultation where the allergy was first recorded.

Example
<extension>
    <url value="http://hl7.org/fhir/StructureDefinition/encounter-associatedEncounter" />
    <valueReference value="urn:uuid:85acc1ae-6b9d-4a9f-9840-60d6cac081cd" />
</extension>


extension(allergyEnd)

Usage

Required

Guidance

The extension.allergyEnd contains the endDate and endReason for when the allergy or intolerance was recorded as resolved.

It MUST be populated if the clinicalStatus has the value of resolved.

  • The endDate element is the date that the allergy or intolerance was recorded as resolved.
  • The reasonEnded element is the reason that the allergy or intolerance was resolved.
Note: The value "No information available" can be used in exception circumstances where a reason has not been recorded. For example, legacy data may not contain the reason.
Example
<extension>
    <url value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-AllergyIntoleranceEnd-1" />
    <extension>
        <endDate>
            <valueDateTime value="2022-07-07T14:07:48+00:00" />
        </endDate>
        <reasonEnded>
            <valueString  value="No information available" />
        </reasonEnded>
    </extension>
</extension>


extension(evidence)

Usage

Optional

Guidance

The extension.evidence does not need to be populated.

Example
<extension>
    <url value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-Evidence-1" />
    <valueReference value="urn:uuid:1554c317-e6a4-4482-bafc-be359d8d1fce" />
</extension>


identifier

Usage

Mandatory

Guidance

The identifier element MUST be populated with a globally unique and persistent identifier (that is, it doesn’t change between requests and therefore stored with the source data). This MUST be scoped by a provider specific namespace for the identifier.

Where consuming systems are integrating data from this resource to their local system, they MUST also persist this identifier at the same time.

Example
<identifier>
    <system value="https://tools.ietf.org/html/rfc4122" />
    <value value="653c0790-a509-4eed-99f3-f42f3683cf2e" />
</identifier>


clinicalStatus

Usage

Mandatory

Guidance

GP systems which support the concept of resolved/ended allergies MUST reflect the status and end date within this profile.

  • active for all active allergies
  • resolved for all resolved allergies
Example
<clinicalStatus value="active" />


verificationStatus

Usage

Mandatory

Guidance
Note: This value is mandatory in the base FHIR resource so cannot be removed. It is not a concept in GP systems and as such meaning MUST NOT be attributed to this field in consuming systems.

The verificationStatus MUST contain a fixed value of unconfirmed.

Example
<verificationStatus value="unconfirmed" />


type

Usage

Optional

Guidance
Note: This value is mandatory in the base FHIR resource so cannot be removed. It is not a concept in GP systems and as such meaning MUST NOT be attributed to this field in consuming systems.

The type MUST be set to allergy for reactions which are allergenic in nature (immunological), a value of intolerance MAY be used to indicate adverse reactions (not immunologic in nature).

Where the type is unknown the type element may be omitted.

Example
<type value="intolerance" />


category

Usage

Mandatory

Guidance

Use medication for all drug allergy types, environment for all non-drug allergies. The other values in the AllergyIntoleranceCategory ValueSet (food and biologicMUST NOT be used.

It is expected that it will always be possible to assign a category of medication for drug allergies or environment for all other types of allergy/intolerance. If it is not possible to distinguish between a drug and non-drug allergy, medication MUST be used. Generally, the choice in a given system is explicit. The GP suppliers MUST follow the categorisation already in use in populating the GP2GP message.

In some cases, the type of allergy/intolerance may be more general - for example, a system designated type of Other or equivalent. In such cases, if the allergy/intolerance entry interacts with prescribing decision support it MUST be assigned a category of medication. Otherwise, the category of environment MUST be used.

Example
<category value="medication" />


criticality

Usage

Required

Guidance

Distinguishes between life-threatening (high) and non-life-threatening (low) potential as well as unable-to-assess. It MAY be used in addition to severity within the reaction element to express severity - for example, systems that support a severity of life-threatening MAY set criticality to high.

It MAY be used in conjunction with reaction / severity by systems which support a severity of life-threatening or equivalent.

Example
<criticality value="high" />


code

Usage

Mandatory

Guidance

The causative agent such as food, drug or substances that has caused or may cause an allergy, intolerance or adverse reaction in this patient.

Systems will evolve to use the specified vocabulary of SNOMED CT concepts from the specified subset. The subset includes products and concepts from the substance and product hierarchies and allows medication concepts from the dm+d SNOMED CT extension.

In the interim this coded element will hold the primary code for the AllergyIntolerance which may in the case of drug allergies be a medication code or a pre-coordinated code which triggers decision support on the system.

Where the AllergyIntolerance has no coded representation in the source system, but is identified as such in the source record then the appropriate degrade code may be used and the text of the AllergyIntolerance placed in the text of the code.

Example
<code>
    <coding>
        <display value="Transfer-degraded drug allergy" />
        <code value="196461000000101" />
        <system value="http://snomed.info/sct" />
        <snomedCT>
            <url value="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid" />
            <extension>
            <valueId value="294801000000114" />
                <descriptionId value="294801000000114" />
                <descriptionDisplay value="Transfer-degraded drug allergy (record artifact)" />
            </extesion>
        </snomedCT>
    </coding>
    <text value="Allergy to paracetemol" />
</code>



patient

Usage

Mandatory

Guidance

A reference to the patient who the allergy / intolerance relates to.

Profile: CareConnect-GPC-Patient-1

Example
<patient>
    <reference value="patient-9929alp" />
</patient>


onset.onsetDateTime

Usage

Required

Guidance

Date when the allergy / intolerance first manifested. Currently restricted to values of dateTime for GP Connect.

This field MUST be populated where the GP system records an explicit onset date for an allergy.

Example
<onset>
    <onsetDateTime value="2011-05-07T00:00:00+00:00" />
</onset>


assertedDate

Usage

Mandatory

Guidance

The datetime the record was believed to be true.

The asserted date is when the allergy related to the patient was asserted. In many cases, this will be when the allergy is recorded onto the system however there are situations where they can differ. For example, if an allergy is asserted during a home visit that is recorded on the clinical system the following day, the asserted date is the date the consultation took place, not the date it was recorded.

Where no asserted date is available, the recorded date is used.

Example
<assertedDate value="2022-07-22T13:24:00+00:00" />


recorder

Usage

Mandatory

Guidance

A reference to the person that recorded the allergy / intolerance.

Example
<recorder>
    <reference value="practitioner-3239exck" />
</recorder>


asserter

Usage

Required

Guidance

Source of the information about the allergy.

Example
<asserter>
    <reference value="practitioner-3239exck" />
</asserter>


lastOccurrence

Usage

Optional

Guidance

Represents the date and/or time of the last known occurrence of a reaction event.

This data item may not currently be available from providing systems and in this circumstance MAY be omitted. Omission SHOULD NOT prejudice the ability of providers and consumers to process this element if and when it is available.

Example
<lastOccurrence value="2022-07-22T13:28:00+00:00" />


note

Usage

Required

Guidance

All text associated with the AllergyIntolerance including user-entered notes and qualifiers is grouped together and expressed in this field, which ensures unmapped coded values or qualifiers are not lost.

Must be used to contain any textual data relevant to the allergy.

Example
<note>
    <author>
        <reference value="practitioner-948392" />
    </author>
    <time value="2022-10-13T16:59:00Z" />
    <text>
        Free text... R4 of the FHIR standard supports GitHub Flavoured Markdown (GFM).
    </text>
</note>


reaction.substance

Usage

Optional

Guidance

The causative is explicitly and specifically coded via AllergyIntolerance.

Example
<reaction>
    <substance>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="762952008" />
            <display value="Peanut (substance)" />
        </coding>
    </substance>
</reaction>


reaction.manifestation

Usage

Optional

Guidance

Conveys the reaction resulting from the allergy / intolerance as a code.

This element is mandatory in the FHIR base profile and so if no data is present please use the nullFlavour as outlined here.

Where no code is available, but a textual description of the reaction is available, then the nullFlavor UNC MAY be used and the textual description conveyed via reaction/description.

If no reaction has explicitly been recorded, but the reaction element is present to convey severity, then reaction/manifestation SHOULD be coded as the nullFlavor NI.

If the patient has been asked, but is unable to specify a reaction the nullFlavor, ASKU SHOULD be used.

Example
<reaction>
    <manifestation>
        <coding>
            <display value="Peanut-induced anaphylaxis" />
            <code value="241933001" />
            <system value="http://snomed.info/sct" />
            <snomedCT>
                <extension>
                  <descriptionId value="362151013" />
                  <descriptionDisplay value="Peanut-induced anaphylaxis (disorder)" />
                </extension>
                <url value="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid" />
            </snomedCT>
        </coding>
        <text value="Anaphalactic shock" />
    </manifestation>
</reaction>


reaction.description

Usage

Optional

Guidance

Conveys the textual description of the manifestation where no code is available.

A consuming system MAY concatenate the contents (appropriately labelled) with text in AllergyIntolerance.note if a textual description of the manifestation is not supported in the receiving system record structure.

Example
<reaction>
    <description value="Vivamus rhoncus mi id urna mattis, a fringilla quam congue." />
</reaction>


reaction.onset

Usage

Optional

Guidance

Onset explicitly supplied via AllergyIntolerance.onset[dateTime].

Example
<reaction>
    <onset value="2022-10-28T08:32:00+00:00" />
</reaction>


reaction.exposureRoute

Usage

Optional

Guidance

The route by which exposure to the substance causing the reaction occurred. Utilise the dm+d route codes.

Example
<reaction>
    <exposureRoute>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="26643006" />
            <display value="Oral" />
        </coding>
    </exposureRoute>
</reaction>


reaction.note

Usage

Optional

Guidance

AllergyIntolerance.note should contain all the consolidated text from the Allergy/Intolerance.

Example
<note>
    <author>
        <reference value="practitioner-0019asb" />
    </author>
    <time value="2022-10-28T08:51:00Z" />
    <text>
        Free text... R4 of the FHIR standard supports GitHub Flavoured Markdown (GFM).
    </text>
</note>

reaction.severity

Usage

Required

Guidance

Severities of Mild, Moderate, Severe are mapped directly to the ValueSet. Map life threatening to Severe and populate criticality with high.

Example
<severity value="Moderate" />


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