| BbsDocumentReference (DocumentReference) | C | | UnContainedComprehensiveDocumentReference | Element idDocumentReference Short descriptionStudy Alternate namesOnderzoek DefinitionImaging study including images and reports.
Usually, this is used for documents other than those defined by FHIR.
UnContainedComprehensiveDocumentReference Constraints- dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty() - dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() - dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() - dom-6: A resource should have narrative for robust management
text.`div`.exists() - dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty() - bbs-DocumentReference-1: Either a category for an image or a report is present.
category.coding.where(system = 'urn:oid:1.3.6.1.4.1.19376.1.2.6.1' and code = 'IMAGES').exists() xor category.coding.where(system = 'urn:oid:1.3.6.1.4.1.19376.1.2.6.1' and code = 'REPORTS').exists() - bbs-DocumentReference-2: For an image or series of images the modalities are specified.
category.coding.where(system = 'urn:oid:1.3.6.1.4.1.19376.1.2.6.1' and code = 'IMAGES').exists() implies context.event.coding.where(system = 'http://dicom.nema.org/resources/ontology/DCM').exists()
Mappings- rim: Entity. Role, or Act
- workflow: Event
- fhircomposition: when describing a Composition
- rim: Document[classCode="DOC" and moodCode="EVN"]
- cda: when describing a CDA
- DocumentEntry-Mapping: XDS DocumentEntry: Used in the context of the IHE MHD ImplementationGuide
- bbs-dataset-100-alpha2-20240208: bbs-dataelement-66
|
| id | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.id Short descriptionLogical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
string |
| meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idDocumentReference.meta Short descriptionMetadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Meta ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.meta.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.meta.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| versionId | Σ | 0..1 | id | There are no (further) constraints on this element Element idDocumentReference.meta.versionId Short descriptionVersion specific identifier DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
id ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| lastUpdated | Σ | 0..1 | instant | There are no (further) constraints on this element Element idDocumentReference.meta.lastUpdated Short descriptionWhen the resource version last changed DefinitionWhen the resource last changed - e.g. when the version changed.
This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
instant ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| source | Σ | 0..1 | uri | There are no (further) constraints on this element Element idDocumentReference.meta.source Short descriptionIdentifies where the resource comes from DefinitionA uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.
In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.
This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
uri ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| profile | Σ | 0..* | canonical(StructureDefinition) | There are no (further) constraints on this element Element idDocumentReference.meta.profile Short descriptionProfiles this resource claims to conform to DefinitionCommentsIt is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
canonical(StructureDefinition) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- DocumentEntry-Mapping: DocumentEntry.limitedMetadata
|
| security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element idDocumentReference.meta.security Short descriptionSecurity Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Coding BindingSecurity Labels from the Healthcare Privacy and Security Classification System.
All Security Labels (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
- rim: CV
- orim: fhir:Coding rdfs:subClassOf dt:CDCoding
|
| tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element idDocumentReference.meta.tag Short descriptionTags applied to this resource DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
Coding BindingCodes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
CommonTags (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
- rim: CV
- orim: fhir:Coding rdfs:subClassOf dt:CDCoding
|
| implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idDocumentReference.implicitRules Short descriptionA set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
uri ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| language | | 0..1 | codeBinding | There are no (further) constraints on this element Element idDocumentReference.language Short descriptionLanguage of the resource content DefinitionThe base language in which the resource is written.
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).
code BindingCommonLanguages (preferred) Binding extensionsConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| text | | 0..1 | Narrative | There are no (further) constraints on this element Element idDocumentReference.text Short descriptionText summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Narrative ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- rim: N/A
- rim: Act.text?
|
| contained | | 0..* | Resource | There are no (further) constraints on this element Element idDocumentReference.contained Short descriptionContained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Resource Mappings- rim: Entity. Role, or Act
- rim: N/A
|
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| modifierExtension | ?! C | 0..0 | Extension | There are no (further) constraints on this element Element idDocumentReference.modifierExtension Short descriptionExtensions that cannot be ignored Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| masterIdentifier | Σ | 1..1 | UniqueIdIdentifier | Element idDocumentReference.masterIdentifier Short descriptionReportInformationIdentificationNumber / ImageInformationIdentificationNumber / UniqueID Alternate namesVerslaginformatieIdentificatienummer, BeeldinformatieIdentificatienummer Definition
- Globally unique ID for the report of the imaging study. In DICOM the study/series UID can be used.
- Globally unique ID that describes the set of images. In DICOM the study/series UID can be used.
- The globally unique identifier assigned by the document creator to this document.
The structure and format of this Id shall be consistent with the specification corresponding to the formatCode attribute. (e.g. for a DICOM standard document a 64-character numeric UID, for an HL7 CDA format a serialization of the CDA Document Id extension and root in the form "oid^extension", where OID is a 64 digits max, and the Id is a 16 UTF-8 char max. If the OID is coded without the extension then the '^' character shall not be included.).
CDA Document Id extension and root.
UniqueIdIdentifier ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- workflow: Event.identifier
- w5: FiveWs.identifier
- fhircomposition: Composition.identifier
- v2: TXA-12
- rim: .id
- xds: DocumentEntry.uniqueId
- cda: ClinicalDocument/id
- DocumentEntry-Mapping: DocumentEntry.uniqueId
- bbs-dataset-100-alpha2-20240208: bbs-dataelement-100
- bbs-dataset-100-alpha2-20240208: bbs-dataelement-784
- ihexds-dataset-2024-20220712: ihexds-dataelement-29
|
| identifier | S Σ | 0..* | Identifier | There are no (further) constraints on this element Element idDocumentReference.identifier Short descriptionOther identifiers for the document DefinitionOther identifiers associated with the document, including version independent identifiers.
Identifier SlicingUnordered, Open, by use(Value) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- workflow: Event.identifier
- w5: FiveWs.identifier
- v2: TXA-16?
- rim: .id / .setId
- xds: DocumentEntry.entryUUID
- DocumentEntry-Mapping: DocumentEntry.entryUUID
|
| entryUUID | Σ | 0..* | EntryUUIDIdentifier | There are no (further) constraints on this element Element idDocumentReference.identifier:entryUUID Short descriptionAn identifier intended for computation DefinitionAn identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.
EntryUUIDIdentifier ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- workflow: Event.identifier
- w5: FiveWs.identifier
- v2: TXA-16?
- rim: .id / .setId
- xds: DocumentEntry.entryUUID
|
| status | Σ ?! | 1..1 | codeBindingPattern | Element idDocumentReference.status Short descriptionAvailabilityStatus DefinitionThe lifecycle status of the document.
This is the status of the DocumentReference object, which might be independent from the docStatus element.
This element is labeled as a modifier because the status contains the codes that mark the document or reference as not currently valid.
code BindingThe status of the document reference.
DocumentReferenceStats (required) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Patterncurrent Mappings- rim: n/a
- workflow: Event.status
- w5: FiveWs.status
- v2: TXA-19
- rim: interim: .completionCode="IN" & ./statusCode[isNormalDatatype()]="active"; final: .completionCode="AU" && ./statusCode[isNormalDatatype()]="complete" and not(./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[subsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("ReviseDocument", code) and isNormalAct()]); amended: .completionCode="AU" && ./statusCode[isNormalDatatype()]="complete" and ./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[subsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("ReviseDocument", code) and isNormalAct() and statusCode="completed"]; withdrawn : .completionCode=NI && ./statusCode[isNormalDatatype()]="obsolete"
- xds: DocumentEntry.availabilityStatus
- DocumentEntry-Mapping: DocumentEntry.availabilityStatus
- ihexds-dataset-2024-20220712: ihexds-dataelement-3
|
| docStatus | Σ | 0..0 | codeBinding | There are no (further) constraints on this element Element idDocumentReference.docStatus Short descriptionpreliminary | final | amended | entered-in-error DefinitionThe status of the underlying document.
The document that is pointed to might be in various lifecycle states.
code BindingStatus of the underlying document.
CompositionStatus (required) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- w5: FiveWs.status
- fhircomposition: Composition.status
- v2: TXA-17
- rim: .statusCode
|
| type | S Σ | 1..1 | CodeableConceptBinding | Element idDocumentReference.type Short descriptionProcedureType / TypeCode Alternate namesVerrichtingType Definition
- Description of the procedure and/or the performed imaging study (e.g. CT thorax, MRI knee, ultrasonography of breast, X-ray).
- The code specifying the precise kind of document (e.g. Pulmonary History and Physical, Discharge Summary, Ultrasound Report).
The value set bound to this element is a thesaurus managed, owned and distributed by DHD (namely the Verrichtingenthesaurus (VT)). Every concept in the VT is linked to a unique SNOMED concept, but it is no SNOMED reference set, and in particular it is not published on the SNOMED browsers. In order to retrieve the contents of the VT, authorized access is required.
The XDS metadata element typeCode, which normally contains the precise type of document, is mapped on .type in core FHIR. In XDS-I, and consequently, the Nictiz IG, the typeCode element is used to indicate the procedure type instead. Even though .context.event is better suited to convey the procedure type from a FHIR perspective, the core FHIR mapping between typeCode and .type is retained.
CodeableConcept BindingPrecise type of clinical document.
VerrichtingTypeDHDCodelijstMetNullFlavor (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- workflow: Event.code
- w5: FiveWs.class
- fhircomposition: Composition.type
- v2: TXA-2
- rim: ./code
- xds: DocumentEntry.type
- cda: ClinicalDocument/code/@code
The typeCode should be mapped from the ClinicalDocument/code element to a set of document type codes configured in the affinity domain. One suggested coding system to use for typeCode is LOINC, in which case the mapping step can be omitted.
- DocumentEntry-Mapping: DocumentEntry.typeCode
- bbs-dataset-100-alpha2-20240208: bbs-dataelement-176
- ihexds-dataset-2024-20220712: ihexds-dataelement-28
|
| category | S Σ | 1..1 | CodeableConcept | Element idDocumentReference.category Short descriptionClassCode Alternate namesclaxs DefinitionThe code specifying the particular kind of document.
Key metadata element describing the the category or classification of the document. This is a broader perspective that groups similar documents based on how they would be used. This is a primary key used in searching.
CodeableConcept BindingHigh-level kind of a clinical document at a macro level.
DocumentClassValueSet (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- w5: FiveWs.class
- fhircomposition: Composition.class
- rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
- xds: DocumentEntry.class
- cda: Derived from a mapping of /ClinicalDocument/code/@code to an Affinity Domain specified coded value to use and coding system. Affinity Domains are encouraged to use the appropriate value for Type of Service, based on the LOINC Type of Service (see Page 53 of the LOINC User's Manual). Must be consistent with /ClinicalDocument/code/@code
- DocumentEntry-Mapping: DocumentEntry.classCode
- ihexds-dataset-2024-20220712: ihexds-dataelement-9
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.category.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.category.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| coding | Σ | 1..* | Coding | Element idDocumentReference.category.coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
Allows for alternative encodings within a code system, and translations to other code systems.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Coding SlicingUnordered, Open, by $this(Value) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
- rim: CV
- orim: fhir:Coding rdfs:subClassOf dt:CDCoding
- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
|
| images | Σ C | 0..1 | CodingPattern | Element idDocumentReference.category.coding:images Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
Allows for alternative encodings within a code system, and translations to other code systems.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Coding ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, bbs-DocumentReference-1, bbs-DocumentReference-2 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern{
"system": "urn:oid:1.3.6.1.4.1.19376.1.2.6.1",
"code": "IMAGES"
}Mappings- rim: n/a
- v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
- rim: CV
- orim: fhir:Coding rdfs:subClassOf dt:CDCoding
- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
|
| reports | Σ C | 0..1 | CodingPattern | Element idDocumentReference.category.coding:reports Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
Allows for alternative encodings within a code system, and translations to other code systems.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Coding ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, bbs-DocumentReference-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern{
"system": "urn:oid:1.3.6.1.4.1.19376.1.2.6.1",
"code": "REPORTS"
}Mappings- rim: n/a
- v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
- rim: CV
- orim: fhir:Coding rdfs:subClassOf dt:CDCoding
- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
|
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.category.text Short descriptionPlain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Very often the text is the same as a displayName of one of the codings.
string ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: C*E.9. But note many systems use C*E.2 for this
- rim: ./originalText[mediaType/code="text/plain"]/data
- orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
|
| subject | S Σ C | 1..1 | Reference(Patient | NlcorePatient) | Element idDocumentReference.subject Short descriptionPatient / PatientId Alternate namesPatient DefinitionWho or what the document is about. The document can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of farm animals, or a set of patients that share a common exposure).
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.
Reference(Patient | NlcorePatient) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow: Event.subject
- w5: FiveWs.subject[x]
- fhircomposition: Composition.subject
- v2: PID-3 (No standard way to define a Practitioner or Group subject in HL7 v2 MDM message)
- rim: .participation[typeCode="SBJ"].role[typeCode="PAT"]
- xds: DocumentEntry.patientId
- cda: ClinicalDocument/recordTarget/
- w5: FiveWs.subject
- DocumentEntry-Mapping: DocumentEntry.patientId
- bbs-dataset-100-alpha2-20240208: bbs-dataelement-132
- ihexds-dataset-2024-20220712: ihexds-dataelement-19
|
| date | S Σ | 1..1 | instant | Element idDocumentReference.date Short descriptionDateTime / CreationTime Alternate namesindexed, DatumTijd Definition
- Date/time on which the report has been autorised and/or made available (if the DocumentReference represents an imaging report).
- Date/time on which the radiological examination has been performed on the patient and/or the images have been made (if the DocumentReference represents an imaging study).
- The time the author created the document. Shall have a single value.
Referencing/indexing time is used for tracking, organizing versions and searching.
instant ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- workflow: Event.occurrence[x]
- w5: FiveWs.recorded
- fhircomposition: Composition.date
- rim: .availabilityTime[type="TS"]
- bbs-dataset-100-alpha2-20240208: bbs-dataelement-101
- bbs-dataset-100-alpha2-20240208: bbs-dataelement-69
- ihexds-dataset-2024-20220712: ihexds-dataelement-11
|
| author | S Σ C | 1..* | Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) | Element idDocumentReference.author Short descriptionAuthor DefinitionIdentifies who is responsible for adding the information to the document.
Not necessarily who did the actual data entry (i.e. typist) or who was the source (informant).
Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) SlicingUnordered, Open, by resolve()(Profile) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow: Event.performer.actor
- fhircomposition: Composition.author
- v2: TXA-9 (No standard way to indicate a Device in HL7 v2 MDM message)
- rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
- xds: DocumentEntry.author
- cda: ClinicalDocument/author
- DocumentEntry-Mapping: DocumentEntry.author
- ihexds-dataset-2024-20220712: ihexds-dataelement-2
|
| location | S Σ C | 1..1 | Reference(NlcoreHealthcareProviderOrganization) | Element idDocumentReference.author:location Short descriptionLocation Alternate namesLocatie DefinitionThe healthcare center where the procedure was, is or will be carried out.
Not necessarily who did the actual data entry (i.e. typist) or who was the source (informant).
Reference(NlcoreHealthcareProviderOrganization) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow: Event.performer.actor
- fhircomposition: Composition.author
- v2: TXA-9 (No standard way to indicate a Device in HL7 v2 MDM message)
- rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
- xds: DocumentEntry.author
- cda: ClinicalDocument/author
- DocumentEntry-Mapping: DocumentEntry.author
- bbs-dataset-100-alpha2-20240208: bbs-dataelement-185
|
| performer | S Σ C | 0..* | Reference(NlcoreHealthProfessionalPractitionerRole) | Element idDocumentReference.author:performer Short descriptionPerformer Alternate namesUitvoerder DefinitionThe health professional who carried out or will carry out the procedure. In most cases, only the medical specialty is entered, and not the name of the health professional. In the context of image exchange, the Performing Physician should be conveyed here, and NOT the laboratory technician who makes the images (i.e. the Operator).
Each occurrence of the zib HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of nl-core-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of nl-core-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance.
In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the nl-core-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile.
Reference(NlcoreHealthProfessionalPractitionerRole) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow: Event.performer.actor
- fhircomposition: Composition.author
- v2: TXA-9 (No standard way to indicate a Device in HL7 v2 MDM message)
- rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
- xds: DocumentEntry.author
- cda: ClinicalDocument/author
- DocumentEntry-Mapping: DocumentEntry.author
- bbs-dataset-100-alpha2-20240208: bbs-dataelement-187
|
| authenticator | C | 0..1 | Reference(Organization | Practitioner | PractitionerRole | NlcoreHealthcareProviderOrganization | NlcoreHealthProfessionalPractitionerRole) | Element idDocumentReference.authenticator Short descriptionLegalAuthenticator DefinitionRepresents a participant who has legally authenticated or attested the document within the author institution.
Each occurrence of the zib HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of nl-core-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of nl-core-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance.
In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the nl-core-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile.
Reference(Organization | Practitioner | PractitionerRole | NlcoreHealthcareProviderOrganization | NlcoreHealthProfessionalPractitionerRole) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow: Event.performer.actor
- w5: FiveWs.witness
- fhircomposition: Composition.attester
- v2: TXA-10
- rim: .participation[typeCode="AUTHEN"].role[classCode="ASSIGNED"]
- xds: DocumentEntry.legalAuthenticator
- cda: ClinicalDocument/legalAuthenticator
- DocumentEntry-Mapping: DocumentEntry.legalAuthenticator
- ihexds-dataset-2024-20220712: ihexds-dataelement-17
|
| custodian | C | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idDocumentReference.custodian Short descriptionOrganization which maintains the document DefinitionIdentifies the organization or group who is responsible for ongoing maintenance of and access to the document.
Identifies the logical organization (software system, vendor, or department) to go to find the current version, where to report issues, etc. This is different from the physical location (URL, disk drive, or server) of the document, which is the technical location of the document, which host may be delegated to the management of some other organization.
Reference(Organization) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow: Event.performer.actor
- fhircomposition: Composition.custodian
- rim: .participation[typeCode="RCV"].role[classCode="CUST"].scoper[classCode="ORG" and determinerCode="INST"]
- DocumentEntry-Mapping: not mapped
|
| relatesTo | S Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idDocumentReference.relatesTo Short descriptionRelationships to other documents DefinitionRelationships that this document has with other document references that already exist.
This element is labeled as a modifier because documents that append to other documents are incomplete on their own.
BackboneElement ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- fhircomposition: Composition.relatesTo
- rim: .outboundRelationship
- xds: DocumentEntry Associations
- DocumentEntry-Mapping: DocumentEntry Associations
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.relatesTo.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.relatesTo.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.relatesTo.modifierExtension Short descriptionExtensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
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.
Extension ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| code | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element idDocumentReference.relatesTo.code Short descriptionreplaces | transforms | signs | appends DefinitionThe type of relationship that this document has with anther document.
If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.
code BindingThe type of relationship between documents.
DocumentRelationshipType (required) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- fhircomposition: Composition.relatesTo.code
- rim: .outboundRelationship.typeCode
- xds: DocumentEntry Associations type
- DocumentEntry-Mapping: DocumentEntry Associations.type
|
| target | Σ C | 1..1 | Reference(DocumentReference) | There are no (further) constraints on this element Element idDocumentReference.relatesTo.target Short descriptionTarget of the relationship DefinitionThe target document of this relationship.
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.
Reference(DocumentReference) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- fhircomposition: Composition.relatesTo.target
- rim: .target[classCode="DOC", moodCode="EVN"].id
- xds: DocumentEntry Associations reference
- DocumentEntry-Mapping: DocumentEntry Associations.reference
|
| description | Σ | 0..1 | string | Element idDocumentReference.description Short descriptionComments DefinitionComments associated with the document.
Helps humans to assess whether the document is of interest.
What the document is about, a terse summary of the document.
string ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: TXA-25
- rim: .outboundRelationship[typeCode="SUBJ"].target.text
- xds: DocumentEntry.comments
- DocumentEntry-Mapping: DocumentEntry.comments
- ihexds-dataset-2024-20220712: ihexds-dataelement-4
|
| securityLabel | S Σ | 1..* | CodeableConceptBinding | Element idDocumentReference.securityLabel Short descriptionConfidentialityCode DefinitionThe code specifying the level of confidentiality of the document.
Use of the Health Care Privacy/Security Classification (HCS) system of security-tag use is recommended.
The confidentiality codes can carry multiple vocabulary items. HL7 has developed an understanding of security and privacy tags that might be desirable in a Document Sharing environment, called HL7 Healthcare Privacy and Security Classification System (HCS). The following specification is recommended but not mandated, as the vocabulary bindings are an administrative domain responsibility. The use of this method is up to the policy domain such as the XDS Affinity Domain or other Trust Domain where all parties including sender and recipients are trusted to appropriately tag and enforce.
In the HL7 Healthcare Privacy and Security Classification (HCS) there are code systems specific to Confidentiality, Sensitivity, Integrity, and Handling Caveats. Some values would come from a local vocabulary as they are related to workflow roles and special projects.
CodeableConcept BindingSecurity Labels from the Healthcare Privacy and Security Classification System.
ConfidentialityCodes (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- fhircomposition: Composition.confidentiality, Composition.meta.security
- v2: TXA-18
- rim: .confidentialityCode
- xds: DocumentEntry.confidentialityCode
- cda: ClinicalDocument/confidentialityCode/@code
- DocumentEntry-Mapping: DocumentEntry.confidentialityCode
- ihexds-dataset-2024-20220712: ihexds-dataelement-10
|
| content | Σ | 1..1 | BackboneElement | There are no (further) constraints on this element Element idDocumentReference.content Short descriptionDocument referenced DefinitionThe document and format referenced.
BackboneElement ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- fhircomposition: Bundle(Composition+*)
- rim: document.text
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.content.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.content.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.content.modifierExtension Short descriptionExtensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
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.
Extension ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| attachment | Σ C | 1..1 | Attachment | There are no (further) constraints on this element Element idDocumentReference.content.attachment Short descriptionWhere to access the document DefinitionThe document or URL of the document along with critical metadata to prove content has integrity.
When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Signed Procedure Consent".
Attachment ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - att-1: If the Attachment has data, it SHALL have a contentType
data.empty() or contentType.exists()
Mappings- rim: n/a
- v2: ED/RP
- rim: ED
- fhircomposition: Composition.language,
Composition.title,
Composition.date
- v2: TXA-3 for mime type
- rim: document.text
- xds: DocumentEntry.mimeType, DocumentEntry.languageCode, DocumentEntry.URI, DocumentEntry.size, DocumentEntry.hash, DocumentEntry.title, DocumentEntry.creationTime
- cda: ClinicalDocument/languageCode, ClinicalDocument/title, ClinicalDocument/date
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.content.attachment.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.content.attachment.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| contentType | Σ | 1..1 | codeBinding | Element idDocumentReference.content.attachment.contentType Short descriptionMimeType DefinitionMIME type of the document.
Processors of the data need to be able to know how to interpret the data.
Note that FHIR strings SHALL NOT exceed 1MB in size
code BindingThe mime type of an attachment. Any valid mime type is allowed.
Mime Types (required) Additional bindingsConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
Generaltext/plain; charset=UTF-8, image/png Mappings- rim: n/a
- v2: ED.2+ED.3/RP.2+RP.3. Note conversion may be needed if old style values are being used
- rim: ./mediaType, ./charset
- DocumentEntry-Mapping: DocumentEntry.mimeType
- ihexds-dataset-2024-20220712: ihexds-dataelement-18
|
| language | S Σ | 1..1 | codeBinding | Element idDocumentReference.content.attachment.language Short descriptionLanguageCode DefinitionSpecifies the human language of character data in the document. Using codes from IETF RFC 3066.
Users need to be able to choose between the languages in a set of attachments.
Note that FHIR strings SHALL NOT exceed 1MB in size
code BindingTaal (extensible) Binding extensionsConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
Generalen-AU Mappings- rim: n/a
- rim: ./language
- DocumentEntry-Mapping: DocumentEntry.languageCode
- ihexds-dataset-2024-20220712: ihexds-dataelement-16
|
| data | | 0..0 | base64Binary | There are no (further) constraints on this element Element idDocumentReference.content.attachment.data Short descriptionData inline, base64ed DefinitionThe actual data of the attachment - a sequence of bytes, base64 encoded.
The data needs to able to be transmitted inline.
The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON.
base64Binary ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: ED.5
- rim: ./data
|
| url | Σ | 1..1 | url | Element idDocumentReference.content.attachment.url Short descriptionURI DefinitionThe URI for the document.
The data needs to be transmitted by reference.
If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data.
url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
Generalhttp://www.acme.com/logo-small.png Mappings- rim: n/a
- v2: RP.1+RP.2 - if they refer to a URL (see v2.6)
- rim: ./reference/literal
- DocumentEntry-Mapping: DocumentEntry.repositoryUniqueId or DocuemntEntry.URI
- ihexds-dataset-2024-20220712: ihexds-dataelement-30
|
| size | Σ | 0..1 | unsignedInt | Element idDocumentReference.content.attachment.size Short descriptionSize DefinitionSize in bytes of the document.
Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all.
The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference.
unsignedInt ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- rim: N/A (needs data type R3 proposal)
- DocumentEntry-Mapping: DocumentEntry.size
- ihexds-dataset-2024-20220712: ihexds-dataelement-24
|
| hash | Σ | 0..1 | base64Binary | Element idDocumentReference.content.attachment.hash Short descriptionHash DefinitionHash of the document itself.
Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version).
The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature.
base64Binary ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- rim: .integrityCheck[parent::ED/integrityCheckAlgorithm="SHA-1"]
- DocumentEntry-Mapping: DocumentEntry.hash
- ihexds-dataset-2024-20220712: ihexds-dataelement-14
|
| title | Σ | 0..1 | string | Element idDocumentReference.content.attachment.title Short descriptionReportTitle / ImageTitle / Title Alternate namesVerslagTitel, BeeldTitel Definition
- The title of the report.
- The title of the image.
- The title of the document.
Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer.
Note that FHIR strings SHALL NOT exceed 1MB in size
string ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
GeneralOfficial Corporate Logo Mappings- rim: n/a
- rim: ./title/data
- DocumentEntry-Mapping: DocumentEntry.title
- bbs-medmij-dataset-100-rc2-20260513: bbs-medmij-dataelement-2
- bbs-medmij-dataset-100-rc2-20260513: bbs-medmij-dataelement-1
- ihexds-dataset-2024-20220712: ihexds-dataelement-27
|
| creation | S Σ | 1..1 | dateTime | Element idDocumentReference.content.attachment.creation Short descriptionDateTime / CreationTime Alternate namesDatumTijd Definition
- Date/time on which the report has been autorised and/or made available (if the DocumentReference represents an imaging report).
- Date/time on which the radiological examination has been performed on the patient and/or the images have been made (if the DocumentReference represents an imaging study).
- The time the author created the document. Shall have a single value.
This is often tracked as an integrity issue for use of the attachment.
dateTime ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- rim: N/A (needs data type R3 proposal)
- DocumentEntry-Mapping: DocumentEntry.creationTime
- bbs-dataset-100-alpha2-20240208: bbs-dataelement-101
- bbs-dataset-100-alpha2-20240208: bbs-dataelement-69
- ihexds-dataset-2024-20220712: ihexds-dataelement-11
|
| format | S Σ | 1..1 | CodingBinding | Element idDocumentReference.content.format Short descriptionFormatCode DefinitionCode globally uniquely specifying the format of the document.
Note that while IHE mostly issues URNs for format types, not all documents can be identified by a URI.
Coding BindingFormatCodes (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
- rim: CV
- orim: fhir:Coding rdfs:subClassOf dt:CDCoding
- fhircomposition: Composition.meta.profile
- rim: document.text
- xds: DocumentEntry.formatCode
- cda: derived from the IHE Profile or Implementation Guide templateID
- DocumentEntry-Mapping: DocumentEntry.formatCode
- ihexds-dataset-2024-20220712: ihexds-dataelement-13
|
| context | Σ | 1..1 | BackboneElement | There are no (further) constraints on this element Element idDocumentReference.context Short descriptionClinical context of document DefinitionThe clinical context in which the document was prepared.
These values are primarily added to help with searching for interesting/relevant documents.
BackboneElement ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- rim: outboundRelationship[typeCode="SUBJ"].target[classCode<'ACT']
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.modifierExtension Short descriptionExtensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
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.
Extension ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| encounter | C | 0..* | Reference(Encounter | EpisodeOfCare | NlcoreEncounter) | Element idDocumentReference.context.encounter Short descriptionReferenceIdList DefinitionA list of identifiers that apply to the document. Identifiers may be Accession Numbers, Order Numbers, Referral Request Identifiers, XDS Workflow Instance Identifiers, etc.
Only Encounters on the ReferenceIdList are conveyed here, while other identifiers on that list are conveyed via .context.related.
Reference(Encounter | EpisodeOfCare | NlcoreEncounter) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow: Event.context
- w5: FiveWs.context
- fhircomposition: Composition.encounter
- rim: unique(highest(./outboundRelationship[typeCode="SUBJ" and isNormalActRelationship()], priorityNumber)/target[moodCode="EVN" and classCode=("ENC", "PCPR") and isNormalAct])
- DocumentEntry-Mapping: DocumentEntry.referenceIdList with CXi encoding for urn:ihe:iti:xds:2015:encounterId
- ihexds-dataset-2024-20220712: ihexds-dataelement-117
|
| event | | 0..* | CodeableConcept | Element idDocumentReference.context.event Short descriptionEventCodeList DefinitionThis list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented.
An event can further specialize the act inherent in the type, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more event codes are included, they shall not conflict with the values inherent in the class or type elements as such a conflict would create an ambiguous situation.
CodeableConcept SlicingUnordered, Open, by $this(Value) BindingThis list of codes represents the main clinical acts being documented.
v3.ActCode (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- fhircomposition: Composition.event.code
- rim: .code
- xds: DocumentEntry.eventCodeList
- DocumentEntry-Mapping: DocumentEntry.eventCodeList
- ihexds-dataset-2024-20220712: ihexds-dataelement-12
|
| procedureAnatomicalLocation | | 0..1 | NlcoreAnatomicalLocationBinding | Element idDocumentReference.context.event:procedureAnatomicalLocation Short descriptionProcedureAnatomicalLocation / Location Alternate namesLocatie, nl-core-AnatomicalLocation, VerrichtingAnatomischeLocatie DefinitionAnatomical location which is the focus of the procedure.
The value set is proposed by IHE MCWG and also suggested for the EU (Xt-EHR). The used value set is a subset of the value set defined in zib2020.
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.
NlcoreAnatomicalLocation BindingThis list of codes represents the main clinical acts being documented.
AnatomicalRegion (required) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- fhircomposition: Composition.event.code
- rim: .code
- xds: DocumentEntry.eventCodeList
- DocumentEntry-Mapping: DocumentEntry.eventCodeList
- zib-anatomicallocation-v1.0-2020EN: NL-CM:20.7.4
- bbs-dataset-100-alpha2-20240208: bbs-dataelement-178
- bbs-dataset-100-alpha2-20240208: bbs-dataelement-179
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.event:procedureAnatomicalLocation.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.event:procedureAnatomicalLocation.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| laterality | C | 0..1 | Extension(CodeableConcept) | There are no (further) constraints on this element Element idDocumentReference.context.event:procedureAnatomicalLocation.extension:laterality Short descriptionOptional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources.
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.
Extension(CodeableConcept) Extension URLhttp://nictiz.nl/fhir/StructureDefinition/ext-AnatomicalLocation.Laterality ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.event:procedureAnatomicalLocation.extension:laterality.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.event:procedureAnatomicalLocation.extension:laterality.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| url | | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idDocumentReference.context.event:procedureAnatomicalLocation.extension:laterality.url Short descriptionidentifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL.
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
uri Fixed valuehttp://nictiz.nl/fhir/StructureDefinition/ext-AnatomicalLocation.Laterality Mappings |
| value[x] | | 0..1 | Binding | Element idDocumentReference.context.event:procedureAnatomicalLocation.extension:laterality.value[x] Short descriptionLaterality Alternate namesLateraliteit DefinitionLaterality adds information about body site to the anatomic location, e.g. left.
LateraliteitCodelijst (required) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- rim: N/A
- zib-anatomicallocation-v1.0-2020EN: NL-CM:20.7.3
- bbs-dataset-100-alpha2-20240208: bbs-dataelement-180
|
| valueCodeableConcept | | | CodeableConcept | There are no (further) constraints on this element Data typeCodeableConcept |
| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idDocumentReference.context.event:procedureAnatomicalLocation.coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
Allows for alternative encodings within a code system, and translations to other code systems.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Coding ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
- rim: CV
- orim: fhir:Coding rdfs:subClassOf dt:CDCoding
- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
|
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.event:procedureAnatomicalLocation.text Short descriptionPlain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Very often the text is the same as a displayName of one of the codings.
string ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: C*E.9. But note many systems use C*E.2 for this
- rim: ./originalText[mediaType/code="text/plain"]/data
- orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
|
| modality | C | 0..* | CodeableConceptBinding | Element idDocumentReference.context.event:modality Short descriptionModality Alternate namesModaliteit DefinitionType of medical imaging device, process or method that originally acquired or produced the data used to create the image or series of images, such as a CT scanner or MRI machine.
For an image or series of images the modalities SHALL be specified.
CodeableConcept BindingThis list of codes represents the main clinical acts being documented.
ModalityCombined (required) Additional bindingsConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, bbs-DocumentReference-2 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- fhircomposition: Composition.event.code
- rim: .code
- xds: DocumentEntry.eventCodeList
- DocumentEntry-Mapping: DocumentEntry.eventCodeList
- bbs-medmij-dataset-100-rc2-20260513: bbs-medmij-dataelement-5
|
| period | S Σ C | 1..1 | Period | There are no (further) constraints on this element Element idDocumentReference.context.period Short descriptionTime of service that is being documented DefinitionThe time period over which the service that is described by the document was provided.
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
Period is not used for a duration (a measure of elapsed time). See Duration.
Period ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings- rim: n/a
- v2: DR
- rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
- fhircomposition: Composition.event.period
- rim: .effectiveTime
- xds: DocumentEntry.serviceStartTime, DocumentEntry.serviceStopTime
- cda: ClinicalDocument/documentationOf/
serviceEvent/effectiveTime/low/
@value --> ClinicalDocument/documentationOf/
serviceEvent/effectiveTime/high/
@value
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.period.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.period.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| start | Σ C | 1..1 | dateTime | Element idDocumentReference.context.period.start Short descriptionProcedureStartDate / ServiceStartTime Alternate namesVerrichtingStartDatum Definition
- Date/time on which the radiological examination has been performed on the patient and/or the images have been made. In practice the time is the instance on which the first image has been taken.
- The start time the service being documented took place.
If the low element is missing, the meaning is that the low boundary is not known.
dateTime ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, per-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: DR.1
- rim: ./low
- DocumentEntry-Mapping: DocumetEntry.serviceStartTime
- bbs-dataset-100-alpha2-20240208: bbs-dataelement-174
- ihexds-dataset-2024-20220712: ihexds-dataelement-22
|
| end | Σ C | 0..1 | dateTime | Element idDocumentReference.context.period.end Short descriptionProcedureEndDate / ServiceStopTime Alternate namesVerrichtingEindDatum Definition
- The end date (and if possible end time) of the procedure. A 'vague' date, such as only the year, is permitted.
The element offers the option to indicate the end of the period of a series of related procedures. The end date element is only used for a procedures that takes some time and is then always applied. If the procedure still continues, the value is left empty. For instantaneous or very short lasting procedures the element is omitted.
- The stop time the service being documented took place.
The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
If the end of the period is missing, it means that the period is ongoing
dateTime ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, per-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: DR.2
- rim: ./high
- DocumentEntry-Mapping: DocumentEntry.serviceStopTime
- bbs-dataset-100-alpha2-20240208: bbs-dataelement-175
- ihexds-dataset-2024-20220712: ihexds-dataelement-23
|
| facilityType | S | 1..1 | CodeableConceptBinding | Element idDocumentReference.context.facilityType Short descriptionOrganizationType / HealthcareFacilityTypeCode Alternate namesOrganisatieType Definition
- The type of healthcare provider, such as general hospital, or nursing home. If this field is filled in and an AGB code is used for the HealthcareProviderIdentificationNumber, the type must match the type implicitly contained in the AGB code.
- This code represents the type of organizational setting of the clinical encounter during which the documented act occurred.
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.
CodeableConcept BindingOrganisatieTypeCodelijst (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- fhircomposition: usually from a mapping to a local ValueSet
- rim: .participation[typeCode="LOC"].role[classCode="DSDLOC"].code
- xds: DocumentEntry.healthcareFacilityTypeCode
- cda: usually a mapping to a local ValueSet. Must be consistent with /clinicalDocument/code
- DocumentEntry-Mapping: DocumentEntry.healthcareFacilityTypeCode
- bbs-dataset-100-alpha2-20240208: bbs-dataelement-546
- ihexds-dataset-2024-20220712: ihexds-dataelement-31
|
| practiceSetting | S | 1..1 | CodeableConceptBinding | Element idDocumentReference.context.practiceSetting Short descriptionDepartmentSpecialty / PracticeSettingCode Alternate namesAfdelingSpecialisme Definition
- The specialty of the healthcare provider's department. The departmental specialty can be filled in if further indication of the healthcare provider is needed. This refers to the recognized medical specialties as stated in the BIG Act.
The bound value set is the value set that has been proposed by IHE MCWG to the EU (Xt-EHR) for national and international exchange.
- The code specifying the clinical specialty where the act that resulted in the document was performed (e.g. Family Practice, Laboratory, Radiology).
This is an important piece of metadata that providers often rely upon to quickly sort and/or filter out to find specific content.
This element should be based on a coarse classification system for the class of specialty practice. Recommend the use of the classification system for Practice Setting, such as that described by the Subject Matter Domain in LOINC.
CodeableConcept BindingAdditional details about where the content was created (e.g. clinical specialty).
PracticeSettingCodeMCWG (required) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- fhircomposition: usually from a mapping to a local ValueSet
- rim: .participation[typeCode="LOC"].role[classCode="DSDLOC"].code
- xds: DocumentEntry.practiceSettingCode
- cda: usually from a mapping to a local ValueSet
- DocumentEntry-Mapping: DocumentEntry.practiceSettingCode
- bbs-dataset-100-alpha2-20240208: bbs-dataelement-524
- ihexds-dataset-2024-20220712: ihexds-dataelement-20
|
| sourcePatientInfo | S C | 1..1 | Reference(Patient | NlcorePatient) | Element idDocumentReference.context.sourcePatientInfo Short descriptionSourcePatientId / SourcePatientInfo Definition
- The sourcePatientId represents the subject of care medical record Identifier (e.g. Patient Id) in the local patient Identifier Domain of the Document Source.
- The sourcePatientInfo contains demographic information of the patient to whose medical record this document belongs.
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.
Reference(Patient | NlcorePatient) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- fhircomposition: Composition.subject
- rim: .participation[typeCode="SBJ"].role[typeCode="PAT"]
- xds: DocumentEntry.sourcePatientInfo, DocumentEntry.sourcePatientId
- cda: ClinicalDocument/recordTarget/
- ihexds-dataset-2024-20220712: ihexds-dataelement-25
- ihexds-dataset-2024-20220712: ihexds-dataelement-26
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.sourcePatientInfo.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.sourcePatientInfo.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| reference | Σ C | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.sourcePatientInfo.reference Short descriptionLiteral reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
string ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- rim: N/A
- DocumentEntry-Mapping: DocumentEntry.sourcePatientInfo
|
| type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idDocumentReference.context.sourcePatientInfo.type Short descriptionType the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
uri BindingAa resource (or, for logical models, the URI of the logical model).
ResourceType (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idDocumentReference.context.sourcePatientInfo.identifier Short descriptionLogical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Identifier ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- rim: .identifier
- DocumentEntry-Mapping: DocumentEntry.sourcePatientId
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.sourcePatientInfo.display Short descriptionText alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
string ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| related | C | 0..* | Reference(Resource) | Element idDocumentReference.context.related Short descriptionReferenceIdList DefinitionA list of identifiers that apply to the document. Identifiers may be Accession Numbers, Order Numbers, Referral Request Identifiers, XDS Workflow Instance Identifiers, etc.
For Imaging (Reports), use the Accession Number with Assigning Authority, Order Number with Assigning Authority and StudyUID, as proposed by the IHE MCWG to support linking the Images and Reports together.
Encounters on the ReferenceIdList are conveyed via .context.encounter.
Reference(Resource) SlicingUnordered, Open, by identifier.type(Value) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- fhircomposition: Composition.event.detail
- rim: ./outboundRelationship[typeCode="PERT" and isNormalActRelationship()] / target[isNormalAct]
- xds: DocumentEntry.referenceIdList
- cda: ClinicalDocument/relatedDocument
- DocumentEntry-Mapping: DocumentEntry.referenceIdList using CXi encoding for type when possible
- ihexds-dataset-2024-20220712: ihexds-dataelement-117
|
| accessionNumber | C | 0..1 | Reference(Resource) | There are no (further) constraints on this element Element idDocumentReference.context.related:accessionNumber Short descriptionRelated identifiers or resources DefinitionRelated identifiers or resources associated with the DocumentReference.
May be identifiers or resources that caused the DocumentReference or referenced Document to be created.
Reference(Resource) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- fhircomposition: Composition.event.detail
- rim: ./outboundRelationship[typeCode="PERT" and isNormalActRelationship()] / target[isNormalAct]
- xds: DocumentEntry.referenceIdList
- cda: ClinicalDocument/relatedDocument
- DocumentEntry-Mapping: DocumentEntry.referenceIdList using CXi encoding for type when possible
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related:accessionNumber.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.related:accessionNumber.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| reference | Σ C | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related:accessionNumber.reference Short descriptionLiteral reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
string ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idDocumentReference.context.related:accessionNumber.type Short descriptionType the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
uri BindingAa resource (or, for logical models, the URI of the logical model).
ResourceType (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| identifier | Σ | 1..1 | Identifier | Element idDocumentReference.context.related:accessionNumber.identifier Short descriptionAccessionNumber Alternate namesAccessionNumber DefinitionA locally unique record number in the RIS that identifies the imaging procedure request.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Identifier ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- rim: .identifier
- bbs-medmij-dataset-100-rc2-20260513: bbs-medmij-dataelement-3
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related:accessionNumber.identifier.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.related:accessionNumber.identifier.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idDocumentReference.context.related:accessionNumber.identifier.use Short descriptionusual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
code BindingIdentifies the purpose for this identifier, if known .
IdentifierUse (required) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: N/A
- rim: Role.code or implied by context
|
| type | Σ | 1..1 | CodeableConceptBindingPattern | Element idDocumentReference.context.related:accessionNumber.identifier.type Short descriptionDescription of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Allows users to make use of identifiers when the identifier system is not known.
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
CodeableConcept BindingA coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Identifier Type Codes (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern{
"coding": [
{
"system": "urn:ietf:rfc:3986",
"code": "urn:ihe:iti:xds:2013:accession"
}
]
}Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2: CX.5
- rim: Role.code or implied by context
|
| system | Σ | 0..1 | uri | Element idDocumentReference.context.related:accessionNumber.identifier.system Short descriptionThe namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique.
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
In DICOM, the Accession Number is just a string (namely of DICOM data type Short String (SH)). In order to ensure uniqueness of the Accession Number, a .system SHOULD be provided. It is up to the Assigning Authority that issued the Accession Number to determine and manage an appropriate URL or URN as .system. If no specific URL or URN for the Accession Number identifier system is provided in the source data, the identifier of the Assigning Authority itself SHOULD be used as fallback, i.e. the OID registered for the Assigning Authority, which should be present in DICOM tag (0040,0032) (Universal Entity ID) as part of (0008,0051) (Issuer of Accession Number Sequence).
uri ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
Generalhttp://www.acme.com/identifiers/patient Mappings- rim: n/a
- v2: CX.4 / EI-2-4
- rim: II.root or Role.id.root
- servd: ./IdentifierType
- bbs-medmij-dataset-100-rc2-20260513: bbs-medmij-dataelement-7
|
| value | Σ | 1..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related:accessionNumber.identifier.value Short descriptionThe value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system.
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
string ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples
General123456 Mappings- rim: n/a
- v2: CX.1 / EI.1
- rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
- servd: ./Value
|
| period | Σ C | 0..1 | Period | There are no (further) constraints on this element Element idDocumentReference.context.related:accessionNumber.identifier.period Short descriptionTime period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use.
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
Period is not used for a duration (a measure of elapsed time). See Duration.
Period ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings- rim: n/a
- v2: DR
- rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
- v2: CX.7 + CX.8
- rim: Role.effectiveTime or implied by context
- servd: ./StartDate and ./EndDate
|
| assigner | Σ C | 0..1 | Reference(Organization | NlcoreHealthcareProviderOrganization) | Element idDocumentReference.context.related:accessionNumber.identifier.assigner Short descriptionAssigningAuthority Alternate namesUitgevendeInstantie DefinitionAssigning authority that issued the Accession Number.
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.
Reference(Organization | NlcoreHealthcareProviderOrganization) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- v2: CX.4 / (CX.4,CX.9,CX.10)
- rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
- servd: ./IdentifierIssuingAuthority
- bbs-medmij-dataset-100-rc2-20260513: bbs-medmij-dataelement-7
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related:accessionNumber.display Short descriptionText alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
string ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| studyInstanceUID | C | 0..1 | Reference(Resource) | There are no (further) constraints on this element Element idDocumentReference.context.related:studyInstanceUID Short descriptionRelated identifiers or resources DefinitionRelated identifiers or resources associated with the DocumentReference.
May be identifiers or resources that caused the DocumentReference or referenced Document to be created.
Reference(Resource) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- fhircomposition: Composition.event.detail
- rim: ./outboundRelationship[typeCode="PERT" and isNormalActRelationship()] / target[isNormalAct]
- xds: DocumentEntry.referenceIdList
- cda: ClinicalDocument/relatedDocument
- DocumentEntry-Mapping: DocumentEntry.referenceIdList using CXi encoding for type when possible
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related:studyInstanceUID.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.related:studyInstanceUID.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| reference | Σ C | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related:studyInstanceUID.reference Short descriptionLiteral reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
string ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, ref-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idDocumentReference.context.related:studyInstanceUID.type Short descriptionType the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
uri BindingAa resource (or, for logical models, the URI of the logical model).
ResourceType (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
| identifier | Σ | 1..1 | Identifier | Element idDocumentReference.context.related:studyInstanceUID.identifier Short descriptionStudyInstanceUID Alternate namesStudyInstanceUID DefinitionThe globally unique DICOM identifier of the imaging study upon which the imaging report is based, assigned by the modality or PACS.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Identifier ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- rim: .identifier
- bbs-medmij-dataset-100-rc2-20260513: bbs-medmij-dataelement-4
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related:studyInstanceUID.identifier.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.related:studyInstanceUID.identifier.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idDocumentReference.context.related:studyInstanceUID.identifier.use Short descriptionusual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
code BindingIdentifies the purpose for this identifier, if known .
IdentifierUse (required) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: n/a
- v2: N/A
- rim: Role.code or implied by context
|
| type | Σ | 1..1 | CodeableConceptBindingPattern | Element idDocumentReference.context.related:studyInstanceUID.identifier.type Short descriptionDescription of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Allows users to make use of identifiers when the identifier system is not known.
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
CodeableConcept BindingA coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Identifier Type Codes (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern{
"coding": [
{
"system": "urn:ietf:rfc:3986",
"code": "urn:ihe:iti:xds:2016:studyInstanceUID"
}
]
}Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2: CX.5
- rim: Role.code or implied by context
|
| system | Σ | 1..1 | uriPattern | Element idDocumentReference.context.related:studyInstanceUID.identifier.system Short descriptionThe namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique.
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Identifier.system is always case sensitive.
uri ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Patternurn:dicom:uid Examples
Generalhttp://www.acme.com/identifiers/patient Mappings- rim: n/a
- v2: CX.4 / EI-2-4
- rim: II.root or Role.id.root
- servd: ./IdentifierType
|
| value | Σ C | 1..1 | string | Element idDocumentReference.context.related:studyInstanceUID.identifier.value Short descriptionThe value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system.
As the Study Instance UID is a DICOM UID, its value SHALL be prefixed with urn:oid:.
string ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - bbs-DocumentReference-3: Each DICOM UID value is a proper OID.
$this.startsWith('urn:oid:')
Examples
General123456 Mappings- rim: n/a
- v2: CX.1 / EI.1
- rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
- servd: ./Value
|
| period | Σ C | 0..1 | Period | There are no (further) constraints on this element Element idDocumentReference.context.related:studyInstanceUID.identifier.period Short descriptionTime period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use.
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
Period is not used for a duration (a measure of elapsed time). See Duration.
Period ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings- rim: n/a
- v2: DR
- rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
- v2: CX.7 + CX.8
- rim: Role.effectiveTime or implied by context
- servd: ./StartDate and ./EndDate
|
| assigner | Σ C | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idDocumentReference.context.related:studyInstanceUID.identifier.assigner Short descriptionOrganization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier.
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.
Reference(Organization) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- v2: CX.4 / (CX.4,CX.9,CX.10)
- rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
- servd: ./IdentifierIssuingAuthority
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related:studyInstanceUID.display Short descriptionText alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
string ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
