| NRL-DocumentReference-1 (DocumentReference) | C | | DocumentReference | There are no (further) constraints on this element Element idDocumentReference Short descriptionA reference to a record DefinitionA reference to a document.
CommentsUsually, this is used for documents other than those defined by FHIR.
Data typeDocumentReference Constraints- dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty() - dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative
contained.text.empty() - dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() - dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
contained.where(('#'+id in %resource.descendants().reference).not()).empty() Mappings- rim: Entity. Role, or Act
- rim: Document[classCode="DOC" and moodCode="EVN"]
- w5: infrastructure.documents
|
| id | Σ | 0..1 | id | 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.
CommentsThe only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Data typeid 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() | (children().count() > id.count()) Mappings |
| 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 may not always be associated with version changes to the resource.
Data typeMeta 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() | (children().count() > id.count()) Mappings |
| 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.
CommentsAsserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.
This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
Data typeuri 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() | (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.
CommentsLanguage is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Data typecode BindingA human language. Common Languages (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() | (children().count() > id.count()) Mappings |
| text | C | 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 may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
CommentsContained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
Data typeNarrative ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, dom-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count()) Mappings- rim: n/a
- rim: N/A
- rim: Act.text?
|
| 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.
CommentsThis 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.
Data typeResource 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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| modifierExtension | ?! C | 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. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| masterIdentifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier Short descriptionMaster Version Specific Identifier DefinitionDocument identifier as assigned by the source of the document. This identifier is specific to this version of the document. This unique identifier may be used elsewhere to identify this version of the document.
RequirementsThe 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.).
CommentsCDA Document Id extension and root.
Data typeIdentifier 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- v2: TXA-12
- rim: .id
- xds: DocumentEntry.uniqueId
- w5: id
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (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.masterIdentifier.use Short descriptionusual | official | temp | secondary (If known) DefinitionThe purpose of this identifier.
RequirementsAllows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
CommentsThis is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Data typecode 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: N/A
- rim: Role.code or implied by context
|
| type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.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.
RequirementsAllows users to make use of identifiers when the identifier system is not known.
CommentsThis 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.
Data typeCodeableConcept 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2: CX.5
- rim: Role.code or implied by context
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.type.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.type.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.type.coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
RequirementsAllows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
CommentsCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data typeCoding 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() | (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
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.type.coding.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.type.coding.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| system | Σ | 0..1 | uri | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.type.coding.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
RequirementsNeed to be unambiguous about the source of the definition of the symbol.
CommentsThe URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Data typeuri 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
|
| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.type.coding.version Short descriptionVersion of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
CommentsWhere the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | Σ | 0..1 | code | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.type.coding.code Short descriptionSymbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
RequirementsNeed to refer to a particular code in the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typecode 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.type.coding.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
RequirementsNeed to be able to carry a human-readable meaning of the code for readers that do not know the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.type.coding.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
RequirementsThis has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
CommentsAmongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data typeboolean 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
|
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.type.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.
RequirementsThe 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.
CommentsVery often the text is the same as a displayName of one of the codings.
Data typestring 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() | (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
|
| system | Σ | 1..1 | uri | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.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.
RequirementsThere 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.
Commentssee http://en.wikipedia.org/wiki/Uniform_resource_identifier
Data typeuri 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() | (children().count() > id.count()) Examples Generalhttp://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri Mappings- rim: n/a
- v2: CX.4 / EI-2-4
- rim: II.root or Role.id.root
- servd: ./IdentifierType
|
| value | Σ | 1..1 | string | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.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.
CommentsIf 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.
Data typestring 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() | (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.masterIdentifier.period Short descriptionTime period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use.
CommentsThis is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
Data typePeriod 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() | (children().count() > id.count()) - per-1: If present, start SHALL have a lower value than end
start.empty() or end.empty() or (start <= end) Mappings- rim: n/a
- v2: DR
- rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
- v2: CX.7 + CX.8
- rim: Role.effectiveTime or implied by context
- servd: ./StartDate and ./EndDate
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.period.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| start | Σ C | 0..1 | dateTime | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.period.start Short descriptionStarting time with inclusive boundary DefinitionThe start of the period. The boundary is inclusive.
CommentsIf the low element is missing, the meaning is that the low boundary is not known.
Data typedateTime 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: DR.1
- rim: ./low
|
| end | Σ C | 0..1 | dateTime | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.period.end Short descriptionEnd time with inclusive boundary, if not ongoing DefinitionThe end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
CommentsThe high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.
Meaning when missingIf the end of the period is missing, it means that the period is ongoing
Data typedateTime 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: DR.2
- rim: ./high
|
| assigner | Σ C | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.assigner Short descriptionOrganization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier.
CommentsThe Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Data typeReference(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() | (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids')) Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- v2: CX.4 / (CX.4,CX.9,CX.10)
- rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
- servd: ./IdentifierIssuingAuthority
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.assigner.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.assigner.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (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.masterIdentifier.assigner.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.
CommentsUsing 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.
Data typestring 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() | (children().count() > id.count()) Mappings |
| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.assigner.identifier Short descriptionLogical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.
CommentsWhen 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.
Data typeIdentifier 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- rim: .identifier
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.masterIdentifier.assigner.display Short descriptionText alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
CommentsThis 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.
Data typestring 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() | (children().count() > id.count()) Mappings |
| identifier | 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.
Data typeIdentifier 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- v2: TXA-16?
- rim: .id / .setId
- xds: DocumentEntry.entryUUID
- w5: id
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.identifier.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (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.identifier.use Short descriptionusual | official | temp | secondary (If known) DefinitionThe purpose of this identifier.
RequirementsAllows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
CommentsThis is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Data typecode 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: N/A
- rim: Role.code or implied by context
|
| type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idDocumentReference.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.
RequirementsAllows users to make use of identifiers when the identifier system is not known.
CommentsThis 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.
Data typeCodeableConcept 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2: CX.5
- rim: Role.code or implied by context
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.identifier.type.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.identifier.type.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idDocumentReference.identifier.type.coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
RequirementsAllows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
CommentsCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data typeCoding 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() | (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
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.identifier.type.coding.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.identifier.type.coding.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| system | Σ | 0..1 | uri | There are no (further) constraints on this element Element idDocumentReference.identifier.type.coding.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
RequirementsNeed to be unambiguous about the source of the definition of the symbol.
CommentsThe URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Data typeuri 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
|
| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.identifier.type.coding.version Short descriptionVersion of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
CommentsWhere the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | Σ | 0..1 | code | There are no (further) constraints on this element Element idDocumentReference.identifier.type.coding.code Short descriptionSymbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
RequirementsNeed to refer to a particular code in the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typecode 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.identifier.type.coding.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
RequirementsNeed to be able to carry a human-readable meaning of the code for readers that do not know the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idDocumentReference.identifier.type.coding.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
RequirementsThis has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
CommentsAmongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data typeboolean 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
|
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.identifier.type.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.
RequirementsThe 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.
CommentsVery often the text is the same as a displayName of one of the codings.
Data typestring 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() | (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
|
| system | Σ | 0..1 | uri | There are no (further) constraints on this element Element idDocumentReference.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.
RequirementsThere 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.
Commentssee http://en.wikipedia.org/wiki/Uniform_resource_identifier
Data typeuri 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() | (children().count() > id.count()) Examples Generalhttp://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri Mappings- rim: n/a
- v2: CX.4 / EI-2-4
- rim: II.root or Role.id.root
- servd: ./IdentifierType
|
| value | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.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.
CommentsIf 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.
Data typestring 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() | (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.identifier.period Short descriptionTime period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use.
CommentsThis is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
Data typePeriod 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() | (children().count() > id.count()) - per-1: If present, start SHALL have a lower value than end
start.empty() or end.empty() or (start <= end) Mappings- rim: n/a
- v2: DR
- rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
- v2: CX.7 + CX.8
- rim: Role.effectiveTime or implied by context
- servd: ./StartDate and ./EndDate
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.identifier.period.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.identifier.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| start | Σ C | 0..1 | dateTime | There are no (further) constraints on this element Element idDocumentReference.identifier.period.start Short descriptionStarting time with inclusive boundary DefinitionThe start of the period. The boundary is inclusive.
CommentsIf the low element is missing, the meaning is that the low boundary is not known.
Data typedateTime 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: DR.1
- rim: ./low
|
| end | Σ C | 0..1 | dateTime | There are no (further) constraints on this element Element idDocumentReference.identifier.period.end Short descriptionEnd time with inclusive boundary, if not ongoing DefinitionThe end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
CommentsThe high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.
Meaning when missingIf the end of the period is missing, it means that the period is ongoing
Data typedateTime 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: DR.2
- rim: ./high
|
| assigner | Σ C | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idDocumentReference.identifier.assigner Short descriptionOrganization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier.
CommentsThe Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Data typeReference(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() | (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids')) Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- v2: CX.4 / (CX.4,CX.9,CX.10)
- rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
- servd: ./IdentifierIssuingAuthority
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.identifier.assigner.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.identifier.assigner.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (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.identifier.assigner.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.
CommentsUsing 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.
Data typestring 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() | (children().count() > id.count()) Mappings |
| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idDocumentReference.identifier.assigner.identifier Short descriptionLogical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.
CommentsWhen 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.
Data typeIdentifier 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- rim: .identifier
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.identifier.assigner.display Short descriptionText alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
CommentsThis 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.
Data typestring 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() | (children().count() > id.count()) Mappings |
| status | Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idDocumentReference.status Short descriptioncurrent | superseded | entered-in-error DefinitionThe status of this document reference.
CommentsThis 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.
Data typecode BindingThe status of the document reference. DocumentReferenceStatus (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() | (children().count() > id.count()) Mappings- rim: n/a
- 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 status
- w5: status
|
| docStatus | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idDocumentReference.docStatus Short descriptionpreliminary | final | appended | amended | entered-in-error DefinitionThe status of the underlying document.
CommentsThe document that is pointed to might be in various lifecycle states.
Data typecode 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: TXA-17
- rim: .statusCode
- w5: status
|
| type | Σ | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idDocumentReference.type Short descriptionKind of record (to be SNOMED) DefinitionSpecifies the particular kind of document referenced (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the document referenced.
CommentsKey metadata element describing the document, used in searching/filtering.
Data typeCodeableConcept BindingPrecise type of clinical record. NRL Record Type (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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2: TXA-2
- rim: ./code
- xds: DocumentEntry.type
- w5: class
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.type.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.type.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| coding | Σ | 1..1 | Coding | There are no (further) constraints on this element Element idDocumentReference.type.coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
RequirementsAllows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
CommentsCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data typeCoding 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() | (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
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.type.coding.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.type.coding.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| system | Σ | 1..1 | uri | There are no (further) constraints on this element Element idDocumentReference.type.coding.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
RequirementsNeed to be unambiguous about the source of the definition of the symbol.
CommentsThe URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Data typeuri 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() | (children().count() > id.count()) Examples URIhttp://snomed.info/sct Mappings- rim: n/a
- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
|
| version | Σ | 0..0 | string | There are no (further) constraints on this element Element idDocumentReference.type.coding.version Short descriptionVersion of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
CommentsWhere the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | Σ | 1..1 | code | There are no (further) constraints on this element Element idDocumentReference.type.coding.code Short descriptionSymbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
RequirementsNeed to refer to a particular code in the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typecode 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() | (children().count() > id.count()) Examples String736253002 Mappings- rim: n/a
- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
| display | Σ | 1..1 | string | There are no (further) constraints on this element Element idDocumentReference.type.coding.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
RequirementsNeed to be able to carry a human-readable meaning of the code for readers that do not know the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idDocumentReference.type.coding.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
RequirementsThis has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
CommentsAmongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data typeboolean 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
|
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.type.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.
RequirementsThe 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.
CommentsVery often the text is the same as a displayName of one of the codings.
Data typestring 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() | (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
|
| class | Σ | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idDocumentReference.class Short descriptionCategorization of document Alternate nameskind DefinitionA categorization for the type of document referenced - helps for indexing and searching. This may be implied by or derived from the code specified in the DocumentReference.type.
RequirementsHelps humans to assess whether the document is of interest when viewing a list of documents.
CommentsThis is a metadata field from XDS/MHD.
Data typeCodeableConcept BindingHigh-level kind of a clinical document at a macro level. NRL Record Class (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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
- xds: DocumentEntry.class
- w5: class
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.class.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.class.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| coding | Σ | 1..1 | Coding | There are no (further) constraints on this element Element idDocumentReference.class.coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
RequirementsAllows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
CommentsCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data typeCoding 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() | (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
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.class.coding.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.class.coding.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| system | Σ | 1..1 | uri | There are no (further) constraints on this element Element idDocumentReference.class.coding.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
RequirementsNeed to be unambiguous about the source of the definition of the symbol.
CommentsThe URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Data typeuri 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
|
| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.class.coding.version Short descriptionVersion of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
CommentsWhere the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | Σ | 1..1 | code | There are no (further) constraints on this element Element idDocumentReference.class.coding.code Short descriptionSymbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
RequirementsNeed to refer to a particular code in the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typecode 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
| display | Σ | 1..1 | string | There are no (further) constraints on this element Element idDocumentReference.class.coding.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
RequirementsNeed to be able to carry a human-readable meaning of the code for readers that do not know the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idDocumentReference.class.coding.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
RequirementsThis has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
CommentsAmongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data typeboolean 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
|
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.class.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.
RequirementsThe 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.
CommentsVery often the text is the same as a displayName of one of the codings.
Data typestring 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() | (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 | Σ C | 1..1 | Reference(Patient) | There are no (further) constraints on this element Element idDocumentReference.subject Short descriptionWho/what is the subject of the record 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).
CommentsReferences 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.
Data typeReference(Patient) 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() | (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids')) Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- v2: PID-3 (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
- w5: who.focus
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.subject.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.subject.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| reference | Σ C | 1..1 | string | There are no (further) constraints on this element Element idDocumentReference.subject.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.
CommentsUsing 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.
Data typestring 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() | (children().count() > id.count()) Examples Referencehttps://demographics.spineservices.nhs.uk/STU3/Patient/6101231234 Mappings |
| identifier | Σ | 0..0 | Identifier | There are no (further) constraints on this element Element idDocumentReference.subject.identifier Short descriptionLogical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.
CommentsWhen 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.
Data typeIdentifier 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- rim: .identifier
|
| display | Σ | 0..0 | string | There are no (further) constraints on this element Element idDocumentReference.subject.display Short descriptionText alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
CommentsThis 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.
Data typestring 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() | (children().count() > id.count()) Mappings |
| created | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element idDocumentReference.created Short descriptionRecord creation time DefinitionWhen the document was created.
CommentsCreation time is used for tracking, organizing versions and searching. This is the creation time of the document, not the source material on which it is based.
Data typedateTime 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: TXA-6
- rim: .effectiveTime[type="TS"]
- xds: DocumentEntry.submissionTime
- w5: when.done
|
| indexed | Σ | 1..1 | instant | There are no (further) constraints on this element Element idDocumentReference.indexed Short descriptionWhen this document reference was created DefinitionWhen the document reference was created.
CommentsReferencing/indexing time is used for tracking, organizing versions and searching.
Data typeinstant 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() | (children().count() > id.count()) Mappings- rim: n/a
- rim: .availabilityTime[type="TS"]
- xds: DocumentEntry.submissionTime
- w5: when.recorded
|
| author | Σ C | 1..1 | Reference(Organization) | There are no (further) constraints on this element Element idDocumentReference.author Short descriptionWho and/or what authored the document DefinitionIdentifies who is responsible for adding the information to the document.
CommentsRecord owner
Not necessarily who did the actual data entry (i.e. typist) it in or who was the source (informant).
Data typeReference(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() | (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids')) Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- v2: TXA-9 (No standard way to indicate a Device in HL7 v2 MDM message)
- rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
- xds: DocumentEntry.author
- w5: who.author
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.author.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.author.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| reference | Σ C | 1..1 | string | There are no (further) constraints on this element Element idDocumentReference.author.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.
CommentsUsing 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.
Data typestring 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() | (children().count() > id.count()) Examples Referencehttps://directory.spineservices.nhs.uk/STU3/Organization/RGD Mappings |
| identifier | Σ | 0..0 | Identifier | There are no (further) constraints on this element Element idDocumentReference.author.identifier Short descriptionLogical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.
CommentsWhen 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.
Data typeIdentifier 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- rim: .identifier
|
| display | Σ | 0..0 | string | There are no (further) constraints on this element Element idDocumentReference.author.display Short descriptionText alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
CommentsThis 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.
Data typestring 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() | (children().count() > id.count()) Mappings |
| authenticator | Σ C | 0..1 | Reference(Organization | Practitioner) | There are no (further) constraints on this element Element idDocumentReference.authenticator Short descriptionWho/what authenticated the document DefinitionWhich person or organization authenticates that this document is valid.
CommentsRepresents a participant within the author institution who has legally authenticated or attested the document. Legal authentication implies that a document has been signed manually or electronically by the legal Authenticator.
Data typeReference(Organization | Practitioner) 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() | (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids')) Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- v2: TXA-10
- rim: .participation[typeCode="AUTHEN"].role[classCode="ASSIGNED"]
- xds: DocumentEntry.legalAuthenticator
- w5: who.witness
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.authenticator.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.authenticator.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (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.authenticator.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.
CommentsUsing 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.
Data typestring 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() | (children().count() > id.count()) Mappings |
| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idDocumentReference.authenticator.identifier Short descriptionLogical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.
CommentsWhen 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.
Data typeIdentifier 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- rim: .identifier
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.authenticator.display Short descriptionText alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
CommentsThis 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.
Data typestring 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() | (children().count() > id.count()) Mappings |
| custodian | Σ C | 1..1 | Reference(Organization) | There are no (further) constraints on this element Element idDocumentReference.custodian Short descriptionOrganization which maintains the record DefinitionIdentifies the organization or group who is responsible for ongoing maintenance of and access to the document.
CommentsEntry/ Pointer owner
Identifies the logical organization to go to find the current version, where to report issues, etc. This is different from the physical location of the document, which is the technical location of the document, which host may be delegated to the management of some other organization.
Data typeReference(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() | (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids')) Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- rim: .participation[typeCode="RCV"].role[classCode="CUST"].scoper[classCode="ORG" and determinerCode="INST"]
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.custodian.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.custodian.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| reference | Σ C | 1..1 | string | There are no (further) constraints on this element Element idDocumentReference.custodian.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.
CommentsUsing 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.
Data typestring 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() | (children().count() > id.count()) Examples Referencehttps://directory.spineservices.nhs.uk/STU3/Organization/RR8 Mappings |
| identifier | Σ | 0..0 | Identifier | There are no (further) constraints on this element Element idDocumentReference.custodian.identifier Short descriptionLogical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.
CommentsWhen 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.
Data typeIdentifier 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- rim: .identifier
|
| display | Σ | 0..0 | string | There are no (further) constraints on this element Element idDocumentReference.custodian.display Short descriptionText alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
CommentsThis 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.
Data typestring 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() | (children().count() > id.count()) Mappings |
| relatesTo | Σ ?! | 0..1 | 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.
CommentsThis element is labeled as a modifier because documents that append to other documents are incomplete on their own.
Data typeBackboneElement 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() | (children().count() > id.count()) Mappings- rim: n/a
- rim: .outboundRelationship
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.relatesTo.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) 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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (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 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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| code | Σ | 1..1 | codeBindingFixed Value | 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 another document.
CommentsIf this document appends another document, then the document cannot be fully understood without also accessing the referenced document.
Data typecode 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() | (children().count() > id.count()) Fixed valuereplaces Mappings- rim: n/a
- rim: .outboundRelationship.typeCode
- xds: DocumentEntry Associations type
|
| target | Σ C | 1..1 | Reference(NRL-DocumentReference-1) | There are no (further) constraints on this element Element idDocumentReference.relatesTo.target Short descriptionTarget of the relationship DefinitionThe target document of this relationship.
CommentsReferences 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.
Data typeReference(NRL-DocumentReference-1) 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() | (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids')) Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- rim: .target[classCode="DOC", moodCode="EVN"].id
- xds: DocumentEntry Associations reference
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.relatesTo.target.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.relatesTo.target.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (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.relatesTo.target.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.
CommentsUsing 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.
Data typestring 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() | (children().count() > id.count()) Mappings |
| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idDocumentReference.relatesTo.target.identifier Short descriptionLogical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.
CommentsWhen 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.
Data typeIdentifier 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- rim: .identifier
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.relatesTo.target.display Short descriptionText alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
CommentsThis 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.
Data typestring 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() | (children().count() > id.count()) Mappings |
| description | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.description Short descriptionHuman-readable description (title) DefinitionHuman-readable description of the source document. This is sometimes known as the "title".
RequirementsHelps humans to assess whether the document is of interest.
CommentsWhat the document is about, rather than a terse summary of the document. It is commonly the case that records do not have a title and are collectively referred to by the display name of Record code (e.g. a "consultation" or "progress note").
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: TXA-25
- rim: .outboundRelationship[typeCode="SUBJ"].target.text
- xds: DocumentEntry.description
|
| securityLabel | Σ | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element idDocumentReference.securityLabel Short descriptionDocument security-tags DefinitionA set of Security-Tag codes specifying the level of privacy/security of the Document. Note that DocumentReference.meta.security contains the security labels of the "reference" to the document, while DocumentReference.securityLabel contains a snapshot of the security labels on the document the reference refers to.
RequirementsUse of the Health Care Privacy/Security Classification (HCS) system of security-tag use is recommended.
CommentsThe 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.
Data typeCodeableConcept 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2: TXA-18
- rim: .confidentialityCode
- xds: DocumentEntry.confidentialityCode
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.securityLabel.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.securityLabel.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idDocumentReference.securityLabel.coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
RequirementsAllows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
CommentsCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data typeCoding 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() | (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
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.securityLabel.coding.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.securityLabel.coding.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| system | Σ | 0..1 | uri | There are no (further) constraints on this element Element idDocumentReference.securityLabel.coding.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
RequirementsNeed to be unambiguous about the source of the definition of the symbol.
CommentsThe URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Data typeuri 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
|
| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.securityLabel.coding.version Short descriptionVersion of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
CommentsWhere the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | Σ | 0..1 | code | There are no (further) constraints on this element Element idDocumentReference.securityLabel.coding.code Short descriptionSymbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
RequirementsNeed to refer to a particular code in the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typecode 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.securityLabel.coding.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
RequirementsNeed to be able to carry a human-readable meaning of the code for readers that do not know the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idDocumentReference.securityLabel.coding.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
RequirementsThis has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
CommentsAmongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data typeboolean 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
|
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.securityLabel.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.
RequirementsThe 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.
CommentsVery often the text is the same as a displayName of one of the codings.
Data typestring 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() | (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
|
| content | Σ | 1..* | BackboneElement | There are no (further) constraints on this element Element idDocumentReference.content Short descriptionRecord referenced DefinitionThe document and format referenced. There may be multiple content element repetitions, each with a different format.
CommentsData typeBackboneElement 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() | (children().count() > id.count()) Mappings- rim: n/a
- rim: document.text
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.content.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) 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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| contentStability | C | 1..1 | Extension(CodeableConcept)Binding | There are no (further) constraints on this element Element idDocumentReference.content.extension:contentStability Short descriptionRecord content stabilty Alternate namesextensions, user content DefinitionCommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension(CodeableConcept) Extension URLhttps://fhir.nhs.uk/STU3/StructureDefinition/Extension-NRL-ContentStability-1 BindingNRL Content Stability (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() | (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 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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (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.
CommentsWhen providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Attachment".
Data typeAttachment 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() | (children().count() > id.count()) - att-1: It the Attachment has data, it SHALL have a contentType
data.empty() or contentType.exists() Mappings- rim: n/a
- v2: ED/RP
- rim: ED
- v2: TXA-3 for mime type
- rim: document.text
- xds: DocumentEntry.mimeType DocumentEntry.languageCode DocumentEntry.URI DocumentEntry.size DocumentEntry.hash DocumentEntry.title
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.content.attachment.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) 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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (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 | There are no (further) constraints on this element Element idDocumentReference.content.attachment.contentType Short descriptionMime type of the content, with charset etc. DefinitionIdentifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.
RequirementsProcessors of the data need to be able to know how to interpret the data.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typecode BindingThe mime type of an attachment. Any valid mime type is allowed. http://www.rfc-editor.org/bcp/bcp13.txt (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() | (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
|
| language | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idDocumentReference.content.attachment.language Short descriptionHuman language of the content (BCP-47) DefinitionThe human language of the content. The value can be any valid value according to BCP 47.
RequirementsUsers need to be able to choose between the languages in a set of attachments.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typecode BindingA human language. Common Languages (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() | (children().count() > id.count()) Examples Generalen-AU Mappings |
| data | | 0..1 | 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. In XML, represented using base64.
RequirementsThe data needs to able to be transmitted inline.
CommentsThe base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON.
Data typebase64Binary 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: ED.5
- rim: ./data
|
| url | Σ | 1..1 | uri | There are no (further) constraints on this element Element idDocumentReference.content.attachment.url Short descriptionUri where the data can be found DefinitionAn alternative location where the data can be accessed.
RequirementsThe data needs to be transmitted by reference.
CommentsIf 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.
Data typeuri 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() | (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
|
| size | Σ | 0..1 | unsignedInt | There are no (further) constraints on this element Element idDocumentReference.content.attachment.size Short descriptionNumber of bytes of content (if url provided) DefinitionThe number of bytes of data that make up this attachment (before base64 encoding, if that is done).
RequirementsRepresenting the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all.
CommentsThe 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.
Data typeunsignedInt 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() | (children().count() > id.count()) Mappings- rim: n/a
- rim: N/A (needs data type R3 proposal)
|
| hash | Σ | 0..1 | base64Binary | There are no (further) constraints on this element Element idDocumentReference.content.attachment.hash Short descriptionHash of the data (sha-1, base64ed) DefinitionThe calculated hash of the data using SHA-1. Represented using base64.
RequirementsIncluded so that applications can verify that the contents of a location have not changed and so that a signature of the content can implicitly sign the content of an image without having to include the data in the instance or reference the url in the signature.
CommentsThe hash is calculated on the data prior to base64 encoding, if the data is based64 encoded.
Data typebase64Binary 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() | (children().count() > id.count()) Mappings- rim: n/a
- rim: .integrityCheck[parent::ED/integrityCheckAlgorithm="SHA-1"]
|
| title | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.content.attachment.title Short descriptionLabel to display in place of the data DefinitionA label or set of text to display in place of the data.
RequirementsApplications 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.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Examples GeneralOfficial Corporate Logo Mappings- rim: n/a
- rim: ./title/data
|
| creation | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element idDocumentReference.content.attachment.creation Short descriptionDate attachment was first created DefinitionThe date that the attachment was first created.
RequirementsThis is often tracked as an integrity issue for use of the attachment.
Data typedateTime 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() | (children().count() > id.count()) Mappings- rim: n/a
- rim: N/A (needs data type R3 proposal)
|
| format | Σ | 1..1 | CodingBinding | There are no (further) constraints on this element Element idDocumentReference.content.format Short descriptionFormat/content rules for the document DefinitionAn identifier of the document encoding, structure, and template that the document conforms to beyond the base format indicated in the mimeType.
CommentsNote that while IHE mostly issues URNs for format types, not all documents can be identified by a URI.
Data typeCoding BindingDocument Format Codes. NRL Format Code (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() | (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
- rim: document.text
- xds: DocumentEntry.formatCode
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.content.format.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.content.format.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| system | Σ | 1..1 | uri | There are no (further) constraints on this element Element idDocumentReference.content.format.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
RequirementsNeed to be unambiguous about the source of the definition of the symbol.
CommentsThe URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Data typeuri 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
|
| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.content.format.version Short descriptionVersion of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
CommentsWhere the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | Σ | 1..1 | code | There are no (further) constraints on this element Element idDocumentReference.content.format.code Short descriptionSymbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
RequirementsNeed to refer to a particular code in the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typecode 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
| display | Σ | 1..1 | string | There are no (further) constraints on this element Element idDocumentReference.content.format.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
RequirementsNeed to be able to carry a human-readable meaning of the code for readers that do not know the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idDocumentReference.content.format.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
RequirementsThis has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
CommentsAmongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data typeboolean 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
|
| 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.
CommentsThese values are primarily added to help with searching for interesting/relevant documents.
Data typeBackboneElement 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() | (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 descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) 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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (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 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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| encounter | Σ C | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element idDocumentReference.context.encounter Short descriptionContext of the document content DefinitionDescribes the clinical encounter or type of care that the document content is associated with.
CommentsReferences 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.
Data typeReference(Encounter) 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() | (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids')) Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- rim: unique(highest(./outboundRelationship[typeCode="SUBJ" and isNormalActRelationship()], priorityNumber)/target[moodCode="EVN" and classCode=("ENC", "PCPR") and isNormalAct])
- w5: context
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.encounter.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.encounter.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (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.encounter.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.
CommentsUsing 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.
Data typestring 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() | (children().count() > id.count()) Mappings |
| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idDocumentReference.context.encounter.identifier Short descriptionLogical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.
CommentsWhen 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.
Data typeIdentifier 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- rim: .identifier
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.encounter.display Short descriptionText alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
CommentsThis 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.
Data typestring 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() | (children().count() > id.count()) Mappings |
| event | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element idDocumentReference.context.event Short descriptionMain clinical acts documented DefinitionThis list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.
CommentsAn 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.
Data typeCodeableConcept BindingThis list of codes represents the main clinical acts being documented. v3 Code System 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- rim: .code
- xds: DocumentEntry.eventCodeList
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.event.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.event.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idDocumentReference.context.event.coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
RequirementsAllows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
CommentsCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data typeCoding 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() | (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
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.event.coding.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.event.coding.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| system | Σ | 0..1 | uri | There are no (further) constraints on this element Element idDocumentReference.context.event.coding.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
RequirementsNeed to be unambiguous about the source of the definition of the symbol.
CommentsThe URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Data typeuri 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
|
| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.event.coding.version Short descriptionVersion of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
CommentsWhere the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | Σ | 0..1 | code | There are no (further) constraints on this element Element idDocumentReference.context.event.coding.code Short descriptionSymbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
RequirementsNeed to refer to a particular code in the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typecode 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.event.coding.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
RequirementsNeed to be able to carry a human-readable meaning of the code for readers that do not know the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idDocumentReference.context.event.coding.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
RequirementsThis has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
CommentsAmongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data typeboolean 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
|
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.event.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.
RequirementsThe 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.
CommentsVery often the text is the same as a displayName of one of the codings.
Data typestring 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() | (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
|
| period | Σ C | 0..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.
CommentsThis is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
Data typePeriod 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() | (children().count() > id.count()) - per-1: If present, start SHALL have a lower value than end
start.empty() or end.empty() or (start <= end) Mappings- rim: n/a
- v2: DR
- rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
- rim: .effectiveTime
- xds: DocumentEntry.serviceStartTime DocumentEntry.serviceStopTime
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.period.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) 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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| start | Σ C | 0..1 | dateTime | There are no (further) constraints on this element Element idDocumentReference.context.period.start Short descriptionStarting time with inclusive boundary DefinitionThe start of the period. The boundary is inclusive.
CommentsIf the low element is missing, the meaning is that the low boundary is not known.
Data typedateTime 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: DR.1
- rim: ./low
|
| end | Σ C | 0..1 | dateTime | There are no (further) constraints on this element Element idDocumentReference.context.period.end Short descriptionEnd time with inclusive boundary, if not ongoing DefinitionThe end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
CommentsThe high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.
Meaning when missingIf the end of the period is missing, it means that the period is ongoing
Data typedateTime 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: DR.2
- rim: ./high
|
| facilityType | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idDocumentReference.context.facilityType Short descriptionKind of facility where patient was seen DefinitionThe kind of facility where the patient was seen.
CommentsNot 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.
Data typeCodeableConcept BindingXDS Facility Type. Facility Type Code Value Set (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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- rim: .participation[typeCode="LOC"].role[classCode="DSDLOC"].code
- xds: DocumentEntry.healthcareFacilityTypeCode
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.facilityType.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.facilityType.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idDocumentReference.context.facilityType.coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
RequirementsAllows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
CommentsCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data typeCoding 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() | (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
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.facilityType.coding.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.facilityType.coding.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| system | Σ | 0..1 | uri | There are no (further) constraints on this element Element idDocumentReference.context.facilityType.coding.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
RequirementsNeed to be unambiguous about the source of the definition of the symbol.
CommentsThe URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Data typeuri 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
|
| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.facilityType.coding.version Short descriptionVersion of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
CommentsWhere the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | Σ | 0..1 | code | There are no (further) constraints on this element Element idDocumentReference.context.facilityType.coding.code Short descriptionSymbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
RequirementsNeed to refer to a particular code in the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typecode 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.facilityType.coding.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
RequirementsNeed to be able to carry a human-readable meaning of the code for readers that do not know the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idDocumentReference.context.facilityType.coding.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
RequirementsThis has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
CommentsAmongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data typeboolean 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
|
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.facilityType.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.
RequirementsThe 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.
CommentsVery often the text is the same as a displayName of one of the codings.
Data typestring 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() | (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
|
| practiceSetting | Σ | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idDocumentReference.context.practiceSetting Short descriptionAdditional details about where the content was created (e.g. clinical specialty) DefinitionThis property may convey specifics about the practice setting where the content was created, often reflecting the clinical specialty.
RequirementsThis is an important piece of metadata that providers often rely upon to quickly sort and/or filter out to find specific content.
CommentsThe value set for this content has an example binding because it is a value set decided by community policy. Other examples exist for consideration: * HITSP created the table HITSP/C80 Table 2-148 Clinical Specialty Value Set (a value set based upon SNOMED CT which is referenced by Direct (XDR and XDM for Direct Messaging Specification, Version 1), as well as Nationwide Health Information Network (NHIN). Query for Documents, Web Service Interface Specification, V 3.0, 07/27/2011 * ELGA (Austria) (ELGA CDA Implementie-rungsleitfäden Registrierung von CDA Dokumenten für ELGA mit IHE Cross-Enterprise Document Sharing: XDS Metadaten (XDSDocumentEntry), [1.2.40.0.34.7.6.3] * XDS Connect-a-thon practiceSettingCode.
Data typeCodeableConcept BindingAdditional details about where the content was created (e.g. clinical specialty). NRL Practice Setting (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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- rim: .participation[typeCode="LOC"].role[classCode="DSDLOC"].code
- xds: DocumentEntry.practiceSettingCode
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.practiceSetting.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.practiceSetting.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| coding | Σ | 1..1 | Coding | There are no (further) constraints on this element Element idDocumentReference.context.practiceSetting.coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
RequirementsAllows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
CommentsCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data typeCoding 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() | (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
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.practiceSetting.coding.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.practiceSetting.coding.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| system | Σ | 1..1 | uri | There are no (further) constraints on this element Element idDocumentReference.context.practiceSetting.coding.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
RequirementsNeed to be unambiguous about the source of the definition of the symbol.
CommentsThe URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Data typeuri 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
|
| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.practiceSetting.coding.version Short descriptionVersion of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
CommentsWhere the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | Σ | 1..1 | code | There are no (further) constraints on this element Element idDocumentReference.context.practiceSetting.coding.code Short descriptionSymbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
RequirementsNeed to refer to a particular code in the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typecode 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
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| display | Σ | 1..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.practiceSetting.coding.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
RequirementsNeed to be able to carry a human-readable meaning of the code for readers that do not know the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
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| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idDocumentReference.context.practiceSetting.coding.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
RequirementsThis has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
CommentsAmongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data typeboolean 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
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| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.practiceSetting.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.
RequirementsThe 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.
CommentsVery often the text is the same as a displayName of one of the codings.
Data typestring 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() | (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
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| sourcePatientInfo | Σ C | 0..1 | Reference(Patient) | There are no (further) constraints on this element Element idDocumentReference.context.sourcePatientInfo Short descriptionPatient demographics from source DefinitionThe Patient Information as known when the document was published. May be a reference to a version specific, or contained.
CommentsReferences 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.
Data typeReference(Patient) 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() | (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids')) Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- rim: .participation[typeCode="SBJ"].role[typeCode="PAT"]
- xds: DocumentEntry.sourcePatientInfo DocumentEntry.sourcePatientId
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| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.sourcePatientInfo.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) 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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (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.
CommentsUsing 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.
Data typestring 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() | (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 other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.
CommentsWhen 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.
Data typeIdentifier 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- rim: .identifier
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| 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.
CommentsThis 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.
Data typestring 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() | (children().count() > id.count()) Mappings |
| related | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idDocumentReference.context.related Short descriptionRelated identifiers or resources DefinitionRelated identifiers or resources associated with the DocumentReference.
CommentsMay be identifiers or resources that caused the DocumentReference or referenced Document to be created.
Data typeBackboneElement 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() | (children().count() > id.count()) Mappings- rim: n/a
- rim: ./outboundRelationship[typeCode="PERT" and isNormalActRelationship()] / target[isNormalAct]
- xds: DocumentEntry.referenceIdList
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| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.related.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (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.related.modifierExtension Short descriptionExtensions that cannot be ignored 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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier Short descriptionIdentifier of related objects or events DefinitionRelated identifier to this DocumentReference. If both id and ref are present they shall refer to the same thing.
CommentsOrder numbers, accession numbers, XDW workflow numbers.
Data typeIdentifier 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- rim: ./outboundRelationship[typeCode="PERT" and isNormalActRelationship()] / target[isNormalAct] .id
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| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.related.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (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.identifier.use Short descriptionusual | official | temp | secondary (If known) DefinitionThe purpose of this identifier.
RequirementsAllows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
CommentsThis is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Data typecode 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: N/A
- rim: Role.code or implied by context
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| type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idDocumentReference.context.related.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.
RequirementsAllows users to make use of identifiers when the identifier system is not known.
CommentsThis 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.
Data typeCodeableConcept 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2: CX.5
- rim: Role.code or implied by context
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| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.type.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.type.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.type.coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
RequirementsAllows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
CommentsCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data typeCoding 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() | (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
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| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.type.coding.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.type.coding.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| system | Σ | 0..1 | uri | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.type.coding.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
RequirementsNeed to be unambiguous about the source of the definition of the symbol.
CommentsThe URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Data typeuri 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
|
| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.type.coding.version Short descriptionVersion of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
CommentsWhere the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
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| code | Σ | 0..1 | code | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.type.coding.code Short descriptionSymbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
RequirementsNeed to refer to a particular code in the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typecode 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
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| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.type.coding.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
RequirementsNeed to be able to carry a human-readable meaning of the code for readers that do not know the system.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.type.coding.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
RequirementsThis has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
CommentsAmongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data typeboolean 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
|
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.type.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.
RequirementsThe 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.
CommentsVery often the text is the same as a displayName of one of the codings.
Data typestring 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() | (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
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| system | Σ | 0..1 | uri | There are no (further) constraints on this element Element idDocumentReference.context.related.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.
RequirementsThere 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.
Commentssee http://en.wikipedia.org/wiki/Uniform_resource_identifier
Data typeuri 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() | (children().count() > id.count()) Examples Generalhttp://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri Mappings- rim: n/a
- v2: CX.4 / EI-2-4
- rim: II.root or Role.id.root
- servd: ./IdentifierType
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| value | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related.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.
CommentsIf 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.
Data typestring 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() | (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
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| period | Σ C | 0..1 | Period | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.period Short descriptionTime period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use.
CommentsThis is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
Data typePeriod 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() | (children().count() > id.count()) - per-1: If present, start SHALL have a lower value than end
start.empty() or end.empty() or (start <= end) Mappings- rim: n/a
- v2: DR
- rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
- v2: CX.7 + CX.8
- rim: Role.effectiveTime or implied by context
- servd: ./StartDate and ./EndDate
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| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.period.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
| start | Σ C | 0..1 | dateTime | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.period.start Short descriptionStarting time with inclusive boundary DefinitionThe start of the period. The boundary is inclusive.
CommentsIf the low element is missing, the meaning is that the low boundary is not known.
Data typedateTime 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: DR.1
- rim: ./low
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| end | Σ C | 0..1 | dateTime | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.period.end Short descriptionEnd time with inclusive boundary, if not ongoing DefinitionThe end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
CommentsThe high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.
Meaning when missingIf the end of the period is missing, it means that the period is ongoing
Data typedateTime 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: DR.2
- rim: ./high
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| assigner | Σ C | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.assigner Short descriptionOrganization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier.
CommentsThe Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Data typeReference(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() | (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids')) Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- v2: CX.4 / (CX.4,CX.9,CX.10)
- rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
- servd: ./IdentifierIssuingAuthority
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| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.assigner.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.assigner.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (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.identifier.assigner.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.
CommentsUsing 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.
Data typestring 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() | (children().count() > id.count()) Mappings |
| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.assigner.identifier Short descriptionLogical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.
CommentsWhen 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.
Data typeIdentifier 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- rim: .identifier
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| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related.identifier.assigner.display Short descriptionText alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
CommentsThis 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.
Data typestring 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() | (children().count() > id.count()) Mappings |
| ref | Σ C | 0..1 | Reference(Resource) | There are no (further) constraints on this element Element idDocumentReference.context.related.ref Short descriptionRelated Resource DefinitionRelated Resource to this DocumentReference. If both id and ref are present they shall refer to the same thing.
CommentsOrder, ProcedureRequest, Procedure, EligibilityRequest, etc.
Data typeReference(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() | (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids')) Mappings- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- rim: ./outboundRelationship[typeCode="PERT" and isNormalActRelationship()] / target[isNormalAct].text.reference
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| id | | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related.ref.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
CommentsNote that FHIR strings may not exceed 1MB in size
Data typestring 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() | (children().count() > id.count()) Mappings |
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idDocumentReference.context.related.ref.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. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension 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() | (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.ref.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.
CommentsUsing 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.
Data typestring 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() | (children().count() > id.count()) Mappings |
| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idDocumentReference.context.related.ref.identifier Short descriptionLogical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.
CommentsWhen 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.
Data typeIdentifier 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() | (children().count() > id.count()) Mappings- rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- rim: .identifier
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| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idDocumentReference.context.related.ref.display Short descriptionText alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
CommentsThis 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.
Data typestring 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() | (children().count() > id.count()) Mappings |