GP Connect Data Model | FHIR STU3 Representation

<StructureDefinition xmlns="http://hl7.org/fhir">
    <url value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-ClinicalImpression-1" />
    <version value="1.1.0" />
    <name value="CareConnect-GPC-ClinicalImpression-1" />
    <status value="draft" />
    <date value="2023-08-04" />
    <publisher value="NHS England" />
    <description value="A record of a clinical assessment performed to determine what problem(s) may affect the patient and before planning the treatments or management strategies that are best to manage a patient&#39;s condition. Assessments are often 1:1 with a clinical consultation / encounter, but this varies greatly depending on the clinical workflow. This resource is called &quot;ClinicalImpression&quot; rather than &quot;ClinicalAssessment&quot; to avoid confusion with the recording of assessment tools such as Apgar score." />
    <copyright value="Copyright &#169; 2023 NHS England" />
    <fhirVersion value="3.0.2" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="ClinicalImpression" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/ClinicalImpression" />
    <derivation value="constraint" />
    <snapshot>
        <element id="ClinicalImpression">
            <path value="ClinicalImpression" />
            <short value="A clinical assessment performed when planning treatments and management strategies for a patient" />
            <definition value="A record of a clinical assessment performed to determine what problem(s) may affect the patient and before planning the treatments or management strategies that are best to manage a patient&#39;s condition. Assessments are often 1:1 with a clinical consultation / encounter,  but this varies greatly depending on the clinical workflow. This resource is called &quot;ClinicalImpression&quot; rather than &quot;ClinicalAssessment&quot; to avoid confusion with the recording of assessment tools such as Apgar score." />
            <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)" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </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)" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </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))" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </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))]))" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="Entity. Role, or Act" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="Partial mapping for problem evaluation" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="clinical.general" />
            </mapping>
        </element>
        <element id="ClinicalImpression.id">
            <path value="ClinicalImpression.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="ClinicalImpression.meta">
            <path value="ClinicalImpression.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="ClinicalImpression.implicitRules">
            <path value="ClinicalImpression.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="ClinicalImpression.language">
            <path value="ClinicalImpression.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="ClinicalImpression.text">
            <path value="ClinicalImpression.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="ClinicalImpression.contained">
            <path value="ClinicalImpression.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="ClinicalImpression.extension">
            <path value="ClinicalImpression.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" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </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;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="ClinicalImpression.modifierExtension">
            <path value="ClinicalImpression.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" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </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;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </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="ClinicalImpression.identifier">
            <path value="ClinicalImpression.identifier" />
            <short value="Business identifier" />
            <definition value="A unique identifier assigned to the clinical impression that remains consistent regardless of what server the impression is stored on." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="ClinicalImpression.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="PID-3" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="id" />
            </mapping>
        </element>
        <element id="ClinicalImpression.identifier.id">
            <path value="ClinicalImpression.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="ClinicalImpression.identifier.extension">
            <path value="ClinicalImpression.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" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </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;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="ClinicalImpression.identifier.use">
            <path value="ClinicalImpression.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="ClinicalImpression.identifier.type">
            <path value="ClinicalImpression.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="ClinicalImpression.identifier.system">
            <path value="ClinicalImpression.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="0" />
            <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" />
            </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="ClinicalImpression.identifier.value">
            <path value="ClinicalImpression.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="0" />
            <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="ClinicalImpression.identifier.period">
            <path value="ClinicalImpression.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" />
                <source value="http://hl7.org/fhir/StructureDefinition/Period" />
            </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)" />
                <source value="http://hl7.org/fhir/StructureDefinition/Period" />
            </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="ClinicalImpression.identifier.assigner">
            <path value="ClinicalImpression.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="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-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" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </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;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </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="ClinicalImpression.status">
            <path value="ClinicalImpression.status" />
            <short value="draft | completed | entered-in-error" />
            <definition value="Identifies the workflow status of the assessment." />
            <comment value="This element is labeled as a modifier because the status contains the code entered-in-error that marks the clinical impression as not currently valid." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="ClinicalImpression.status" />
                <min value="1" />
                <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="ClinicalImpressionStatus" />
                </extension>
                <strength value="required" />
                <description value="The workflow state of a clinical impression." />
                <valueSetReference>
                    <reference value="http://hl7.org/fhir/ValueSet/clinical-impression-status" />
                </valueSetReference>
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="PRB-14" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="status" />
            </mapping>
        </element>
        <element id="ClinicalImpression.code">
            <path value="ClinicalImpression.code" />
            <short value="Kind of assessment performed" />
            <definition value="Categorizes the type of clinical assessment performed." />
            <comment value="This is present as a place-holder only and may be removed based on feedback/work group opinion." />
            <alias value="type" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="ClinicalImpression.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="ClinicalImpressionCode" />
                </extension>
                <strength value="example" />
                <description value="Identifies categories of clinical impressions.  This is a place-holder only.  It may be removed" />
            </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="w5" />
                <map value="what" />
            </mapping>
        </element>
        <element id="ClinicalImpression.description">
            <path value="ClinicalImpression.description" />
            <short value="Why/how the assessment was performed" />
            <definition value="A summary of the context and/or cause of the assessment - why / where was it performed, and what patient events/status prompted it." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="ClinicalImpression.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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="ClinicalImpression.subject">
            <path value="ClinicalImpression.subject" />
            <short value="Patient or group assessed" />
            <definition value="The patient or group of individuals assessed as part of this record." />
            <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." />
            <requirements value="Group is typically for veterinary and/or public health purposes." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="ClinicalImpression.subject" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
            </type>
            <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" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </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;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </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="w5" />
                <map value="who.focus" />
            </mapping>
        </element>
        <element id="ClinicalImpression.context">
            <path value="ClinicalImpression.context" />
            <short value="Encounter or Episode created from" />
            <definition value="The encounter or episode of care this impression was created as part of." />
            <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="encounter" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="ClinicalImpression.context" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Encounter-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" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </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;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </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="w5" />
                <map value="context" />
            </mapping>
        </element>
        <element id="ClinicalImpression.effective[x]">
            <path value="ClinicalImpression.effective[x]" />
            <short value="Time of assessment" />
            <definition value="The point in time or period over which the subject was assessed." />
            <comment value="This SHOULD be accurate to at least the minute, though some assessments only have a known date." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="ClinicalImpression.effective[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="PRB-2" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="when.done" />
            </mapping>
        </element>
        <element id="ClinicalImpression.date">
            <path value="ClinicalImpression.date" />
            <short value="When the assessment was documented" />
            <definition value="Indicates when the documentation of the assessment was complete." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="ClinicalImpression.date" />
                <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="w5" />
                <map value="when.recorded" />
            </mapping>
        </element>
        <element id="ClinicalImpression.assessor">
            <path value="ClinicalImpression.assessor" />
            <short value="The clinician performing the assessment" />
            <definition value="The clinician performing the assessment." />
            <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="ClinicalImpression.assessor" />
                <min value="0" />
                <max value="1" />
            </base>
            <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" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </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;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </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="ROL-4" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="who.author" />
            </mapping>
        </element>
        <element id="ClinicalImpression.previous">
            <path value="ClinicalImpression.previous" />
            <short value="Reference to last assessment" />
            <definition value="A reference to the last assesment that was conducted bon this patient. Assessments are often/usually ongoing in nature; a care provider (practitioner or team) will make new assessments on an ongoing basis as new data arises or the patient&#39;s conditions changes." />
            <comment value="It is always likely that multiple previous assessments exist for a patient. The point of quoting a previous assessment is that this assessment is relative to it (see resolved)." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="ClinicalImpression.previous" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-ClinicalImpression-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" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </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;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </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>
        </element>
        <element id="ClinicalImpression.problem">
            <path value="ClinicalImpression.problem" />
            <short value="Relevant impressions of patient state" />
            <definition value="This a list of the relevant problems/conditions for a patient." />
            <comment value="e.g. The patient is a pregnant, and cardiac congestive failure, ‎Adenocarcinoma, and is allergic to penicillin." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="ClinicalImpression.problem" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Condition-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-AllergyIntolerance-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" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </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;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </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="PRB-3 / IAM-7" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="why" />
            </mapping>
        </element>
        <element id="ClinicalImpression.investigation">
            <path value="ClinicalImpression.investigation" />
            <short value="One or more sets of investigations (signs, symptions, etc.)" />
            <definition value="One or more sets of investigations (signs, symptions, etc.). The actual grouping of investigations vary greatly depending on the type and context of the assessment. These investigations may include data generated during the assessment process, or data previously generated and recorded that is pertinent to the outcomes." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="ClinicalImpression.investigation" />
                <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>
        </element>
        <element id="ClinicalImpression.investigation.id">
            <path value="ClinicalImpression.investigation.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="ClinicalImpression.investigation.extension">
            <path value="ClinicalImpression.investigation.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" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </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;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="ClinicalImpression.investigation.modifierExtension">
            <path value="ClinicalImpression.investigation.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" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </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;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </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="ClinicalImpression.investigation.code">
            <path value="ClinicalImpression.investigation.code" />
            <short value="A name/code for the set" />
            <definition value="A name/code for the group (&quot;set&quot;) of investigations. Typically, this will be something like &quot;signs&quot;, &quot;symptoms&quot;, &quot;clinical&quot;, &quot;diagnostic&quot;, but the list is not constrained, and others such groups such as (exposure|family|travel|nutitirional) history may be used." />
            <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="ClinicalImpression.investigation.code" />
                <min value="1" />
                <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="InvestigationGroupType" />
                </extension>
                <strength value="example" />
                <description value="A name/code for a set of investigations." />
                <valueSetReference>
                    <reference value="http://hl7.org/fhir/ValueSet/investigation-sets" />
                </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>
        </element>
        <element id="ClinicalImpression.investigation.item">
            <path value="ClinicalImpression.investigation.item" />
            <short value="Record of a specific investigation" />
            <definition value="A record of a specific investigation that was undertaken." />
            <comment value="Most investigations are observations of one kind of or another but some other specific types of data collection resources can also be used." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="ClinicalImpression.investigation.item" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/FamilyMemberHistory" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/RiskAssessment" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingStudy" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Observation-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-DiagnosticReport-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" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </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;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </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="v2" />
                <map value="OBX-21" />
            </mapping>
        </element>
        <element id="ClinicalImpression.protocol">
            <path value="ClinicalImpression.protocol" />
            <short value="Clinical Protocol followed" />
            <definition value="Reference to a specific published clinical protocol that was followed during this assessment, and/or that provides evidence in support of the diagnosis." />
            <comment value="see http://en.wikipedia.org/wiki/Uniform_resource_identifier" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="ClinicalImpression.protocol" />
                <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>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="ClinicalImpression.summary">
            <path value="ClinicalImpression.summary" />
            <short value="Summary of the assessment" />
            <definition value="A text summary of the investigations and the diagnosis." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="ClinicalImpression.summary" />
                <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="v2" />
                <map value="OBX" />
            </mapping>
        </element>
        <element id="ClinicalImpression.finding">
            <path value="ClinicalImpression.finding" />
            <short value="Possible or likely findings and diagnoses" />
            <definition value="Specific findings or diagnoses that was considered likely or relevant to ongoing treatment." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="ClinicalImpression.finding" />
                <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>
        </element>
        <element id="ClinicalImpression.finding.id">
            <path value="ClinicalImpression.finding.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="ClinicalImpression.finding.extension">
            <path value="ClinicalImpression.finding.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" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </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;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="ClinicalImpression.finding.modifierExtension">
            <path value="ClinicalImpression.finding.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" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </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;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </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="ClinicalImpression.finding.item[x]">
            <path value="ClinicalImpression.finding.item[x]" />
            <short value="What was found" />
            <definition value="Specific text, code or reference for finding or diagnosis, which may include ruled-out or resolved conditions." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="ClinicalImpression.finding.item[x]" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-ProblemHeader-Condition-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Observation-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>
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ConditionKind" />
                </extension>
                <strength value="example" />
                <description value="Identification of the Condition or diagnosis." />
                <valueSetReference>
                    <reference value="http://hl7.org/fhir/ValueSet/condition-code" />
                </valueSetReference>
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="OBX" />
            </mapping>
        </element>
        <element id="ClinicalImpression.finding.basis">
            <path value="ClinicalImpression.finding.basis" />
            <short value="Which investigations support finding" />
            <definition value="Which investigations support finding or diagnosis." />
            <comment value="Note that FHIR strings may not exceed 1MB in size" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="ClinicalImpression.finding.basis" />
                <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="ClinicalImpression.prognosisCodeableConcept">
            <path value="ClinicalImpression.prognosisCodeableConcept" />
            <short value="Estimate of likely outcome" />
            <definition value="Estimate of likely outcome." />
            <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="ClinicalImpression.prognosisCodeableConcept" />
                <min value="0" />
                <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="ClinicalImpressionPrognosis" />
                </extension>
                <strength value="example" />
                <description value="Prognosis or outlook findings" />
                <valueSetReference>
                    <reference value="http://hl7.org/fhir/ValueSet/clinicalimpression-prognosis" />
                </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="PRB-22" />
            </mapping>
        </element>
        <element id="ClinicalImpression.prognosisReference">
            <path value="ClinicalImpression.prognosisReference" />
            <short value="RiskAssessment expressing likely outcome" />
            <definition value="RiskAssessment expressing likely outcome." />
            <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="*" />
            <base>
                <path value="ClinicalImpression.prognosisReference" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/RiskAssessment" />
            </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" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </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;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </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>
        </element>
        <element id="ClinicalImpression.action">
            <path value="ClinicalImpression.action" />
            <short value="Action taken as part of assessment procedure" />
            <definition value="Action taken as part of assessment procedure." />
            <comment value="Actions recommended as a result of the impression should not be captured using the &#39;action&#39; element." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="ClinicalImpression.action" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-ReferralRequest-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-ProcedureRequest-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationRequest-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Appointment-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" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </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;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </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>
        </element>
        <element id="ClinicalImpression.note">
            <path value="ClinicalImpression.note" />
            <short value="Comments made about the ClinicalImpression" />
            <definition value="Commentary about the impression, typically recorded after the impression itself was made, though supplemental notes by the original author could also appear." />
            <comment value="Don&#39;t use this element for content that should more properly appear as one of the specific elements of the impression." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="ClinicalImpression.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>
        </element>
    </snapshot>
    <differential>
        <element id="ClinicalImpression.identifier.assigner">
            <path value="ClinicalImpression.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-1" />
            </type>
        </element>
        <element id="ClinicalImpression.subject">
            <path value="ClinicalImpression.subject" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
            </type>
        </element>
        <element id="ClinicalImpression.context">
            <path value="ClinicalImpression.context" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Encounter-1" />
            </type>
        </element>
        <element id="ClinicalImpression.assessor">
            <path value="ClinicalImpression.assessor" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1" />
            </type>
        </element>
        <element id="ClinicalImpression.previous">
            <path value="ClinicalImpression.previous" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-ClinicalImpression-1" />
            </type>
        </element>
        <element id="ClinicalImpression.problem">
            <path value="ClinicalImpression.problem" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Condition-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-AllergyIntolerance-1" />
            </type>
        </element>
        <element id="ClinicalImpression.investigation.item">
            <path value="ClinicalImpression.investigation.item" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/FamilyMemberHistory" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/RiskAssessment" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingStudy" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Observation-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-DiagnosticReport-1" />
            </type>
        </element>
        <element id="ClinicalImpression.summary">
            <path value="ClinicalImpression.summary" />
            <min value="1" />
        </element>
        <element id="ClinicalImpression.finding.item[x]">
            <path value="ClinicalImpression.finding.item[x]" />
            <type>
                <code value="CodeableConcept" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-ProblemHeader-Condition-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Observation-1" />
            </type>
        </element>
        <element id="ClinicalImpression.action">
            <path value="ClinicalImpression.action" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-ReferralRequest-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-ProcedureRequest-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationRequest-1" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Appointment-1" />
            </type>
        </element>
    </differential>
</StructureDefinition>