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Pan-Canadian Patient Summary (PS-CA) v2.1.0 DFT

2.1.0-DFT   Canada flag
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  • FHIR Artifacts
    • FHIR Artifacts
    • PS-CA Library of Profiles
    • Bundle (PS-CA)
    • Composition (PS-CA)
    • Patient (PS-CA)
    • Medication (PS-CA)
    • MedicationRequest (PS-CA)
    • MedicationStatement (PS-CA)
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    • Observation Laboratory/Pathology (PS-CA)
    • Observation Radiology (PS-CA)
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    • Data Type Profiles
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  • Change Log
    1. Index
    2. FHIR Artifacts
    3. Composition (PS-CA)

DFT - For a full list of available versions, see the Directory of published versions

Composition (PS-CA)

Links

Profile

composition-ca-ps

Derived from

http://hl7.org/fhir/StructureDefinition/Composition

Examples

Composition1Example

Description

This profile represents the constraints applied to the Composition resource by the PS-CA project. A Canadian Patient Summary (PS-CA) document is an electronic health record extract containing essential healthcare information about a subject of care. It is informed by the IPS-UV Composition profile, but differs in its application of Must Support flags on some of the sections to allow for jurisdictional implementors flexibility in what sections systems Must Support in order to show conformance to their respective patient summaries. The PS-CA dataset is minimal and non-exhaustive; specialty-agnostic and condition-independent; but still clinically relevant. It is informed by the requirements specified in EN 17269 and ISO/DIS 27269, it is designed for supporting the international use case scenario for ‘unplanned, cross border care’, but is also designed to support a variety of use cases for cross-jurisdiction exchange. It is intended to guide implementation nationally while ensuring international exchange of patient summaries is not impeded.

This profile is based on the ClinicalDocument profile from the base R4 FHIR standard.

References to this resource

CompositionPSCA

Resource Content

  • Tree view
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  • XML
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CompositionPSCA (Composition)CCompositionElement id
Composition
Short description

Canadian Patient Summary composition

Definition

Canadian Patient Summary composition. A composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained.

Comments

While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

Data type

Composition

Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
Mappings
  • rim: Entity. Role, or Act
  • workflow: Event
  • rim: Document[classCode="DOC" and moodCode="EVN" and isNormalAct()]
  • cda: ClinicalDocument
  • fhirdocumentreference: when described by DocumentReference
idΣ0..1string
There are no (further) constraints on this element
Element id
Composition.id
Short description

Logical id of this artifact

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Comments

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

Data type

string

metaΣ0..1Meta
There are no (further) constraints on this element
Element id
Composition.meta
Short description

Metadata about the resource

Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Data type

Meta

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
implicitRulesΣ ?!0..1uri
There are no (further) constraints on this element
Element id
Composition.implicitRules
Short description

A set of rules under which this content was created

Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
language0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.language
Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

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

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions
maxValueSetAllLanguages
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
textS0..1NarrativeElement id
Composition.text
Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: Act.text?
contained0..*Resource
There are no (further) constraints on this element
Element id
Composition.contained
Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Data type

Resource

Mappings
  • rim: N/A
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
modifierExtension?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.modifierExtension
Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
identifierS Σ0..1Identifier
There are no (further) constraints on this element
Element id
Composition.identifier
Short description

Version-independent identifier for the Composition

Definition

A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

Comments

Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

Data type

Identifier

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.identifier
  • w5: FiveWs.identifier
  • rim: Document.id / Document.setId
  • cda: .setId
  • fhirdocumentreference: DocumentReference.masterIdentifier
statusS Σ ?!1..1codeBinding
There are no (further) constraints on this element
Element id
Composition.status
Short description

preliminary | final | amended | entered-in-error

Definition

The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

Requirements

Need to be able to mark interim, amended, or withdrawn compositions or documents.

Comments

If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements.

Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.

Data type

code

Binding

The workflow/clinical status of the composition.

CompositionStatus (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.status
  • w5: FiveWs.status
  • 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("ReviseComposition", code) and isNormalAct()]); amended: .completionCode="AU" && ./statusCode[isNormalDatatype()]="complete" and ./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[subsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("ReviseComposition", code) and isNormalAct() and statusCode="completed"]; withdrawn : .completionCode=NI && ./statusCode[isNormalDatatype()]="obsolete"
  • cda: n/a
  • fhirdocumentreference: DocumentReference.status
typeS Σ1..1CodeableConceptBindingPatternElement id
Composition.type
Short description

Kind of composition ("Patient Summary")

Definition

Specifies that this composition refers to a Patient Summary (Loinc "60591-5")

Requirements

Key metadata element describing the composition, used in searching/filtering.

Comments

For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

Data type

CodeableConcept

Binding

Type of a composition.

FHIRDocumentTypeCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "60591-5"
    }
  ]
}
Mappings
  • workflow: Event.code
  • w5: FiveWs.class
  • rim: ./code
  • cda: .code
  • fhirdocumentreference: DocumentReference.type
categoryΣ0..*CodeableConcept
There are no (further) constraints on this element
Element id
Composition.category
Short description

Categorization of Composition

Definition

A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.

Requirements

Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.

Comments

This is a metadata field from XDS/MHD.

Data type

CodeableConcept

Binding

High-level kind of a clinical document at a macro level.

DocumentClassValueSet (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.subject
  • w5: FiveWs.class
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
  • cda: n/a
  • fhirdocumentreference: DocumenttReference.category
subjectS Σ1..1Reference(PatientPSCA)Element id
Composition.subject
Short description

Who and/or what the composition is about

Definition

Who or what the composition is about. In general a composition 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 livestock, or a set of patients that share a common exposure). For the PS the subject is always the patient.

Requirements

Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.

Comments

For clinical documents, this is usually the patient.

Data type

Reference(PatientPSCA)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.subject[x]
  • rim: .participation[typeCode="SBJ"].role[typeCode="PAT"]
  • cda: .recordTarget
  • fhirdocumentreference: DocumentReference.subject
  • w5: FiveWs.subject
id0..1string
There are no (further) constraints on this element
Element id
Composition.subject.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.subject.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
referenceS Σ C1..1string
There are no (further) constraints on this element
Element id
Composition.subject.reference
Short description

Literal reference, Relative, internal or absolute URL

Definition

A 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.

Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
typeΣ0..1uriBinding
There are no (further) constraints on this element
Element id
Composition.subject.type
Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Data type

uri

Binding

Aa resource (or, for logical models, the URI of the logical model).

ResourceType (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
identifierΣ0..1Identifier
There are no (further) constraints on this element
Element id
Composition.subject.identifier
Short description

Logical reference, when literal reference is not known

Definition

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Data type

Identifier

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .identifier
displayΣ0..1string
There are no (further) constraints on this element
Element id
Composition.subject.display
Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
encounterΣ0..1Reference(Encounter)Element id
Composition.encounter
Short description

Context of the Composition

Definition

Describes the clinical encounter or type of care this documentation is associated with.

Requirements

Provides context for the composition and supports searching.

Comments

While IPS-UV considers this a Must Support element, policy has not yet been developed in Canada confirming the expectations for when a patient summary is created (e.g., does it have to be created by a health professional or just validated, can it be automatically assembled, does it have to occur within an encounter, etc.). This relaxation does not exclude or prevent implementers from further defining how encounter is used in their implementation if their use case(s) rely on its presence.

Data type

Reference(Encounter)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.context
  • w5: FiveWs.context
  • rim: unique(highest(./outboundRelationship[typeCode="SUBJ" and isNormalActRelationship()], priorityNumber)/target[moodCode="EVN" and classCode=("ENC", "PCPR") and isNormalAct])
  • cda: .componentOf.encompassingEncounter
  • fhirdocumentreference: DocumentReference.context.encounter
dateS Σ1..1dateTime
There are no (further) constraints on this element
Element id
Composition.date
Short description

Composition editing time

Definition

The composition editing time, when the composition was last logically changed by the author.

Requirements

dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.

Comments

The Last Modified Date on the composition may be after the date of the document was attested without being changed.

Data type

dateTime

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.occurrence[x]
  • w5: FiveWs.done[x]
  • rim: .effectiveTime[type="TS"]
  • cda: .effectiveTime
  • fhirdocumentreference: DocumentReference.content.attachment.date, DocumentReference.created
authorS Σ1..*Reference(PractitionerProfile | PractitionerRoleProfile | Device | PatientPSCA | RelatedPerson | OrganizationProfile)Element id
Composition.author
Short description

Who and/or what authored the patient summary

Definition

Identifies who is responsible for the information in the patient summary, not necessarily who typed it in.

The type of author(s) contribute to determine the "nature"of the Patient Summary: e.g., a "human-curated" PS Vs. an "automatically generated" PS.

Requirements

Identifies who is responsible for the content.

Data type

Reference(PractitionerProfile | PractitionerRoleProfile | Device | PatientPSCA | RelatedPerson | OrganizationProfile)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.performer
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
  • fhirdocumentreference: DocumentReference.agent
titleS Σ1..1stringElement id
Composition.title
Short description

CA Patient Summary

Definition

Official human-readable label for the composition.

For this document should be "CA Patient Summary" or any equivalent translation

Comments

For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
  • fhirdocumentreference: DocumentReference.description, DocumentReference.content.attachment.title
confidentialityΣ0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.confidentiality
Short description

As defined by affinity domain

Definition

The code specifying the level of confidentiality of the Composition.

Comments

The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.

Data type

code

Binding

Codes specifying the level of confidentiality of the composition.

v3.ConfidentialityClassification (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .confidentialityCode
  • cda: .confidentialityCode
  • fhirdocumentreference: DocumentReference.securityLabel
attester0..*BackboneElementElement id
Composition.attester
Short description

Attests to accuracy of composition

Definition

A participant who has attested to the accuracy of the composition/document.

Requirements

Identifies responsibility for the accuracy of the composition content.

Comments

IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported across workflows of Canadian jurisdictional implementers.

These challenges have been raised in IPS. Further assessment of jurisdictional use cases need to be explored by the Patient Summary Working Group before the constraint will be re-considered for inclusion

Data type

BackboneElement

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .participation[typeCode="AUTHEN"].role[classCode="ASSIGNED"]
  • cda: .authenticator/.legalAuthenticator
  • fhirdocumentreference: DocumentReference.authenticator
id0..1string
There are no (further) constraints on this element
Element id
Composition.attester.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.attester.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.attester.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
modeS1..1codeBindingElement id
Composition.attester.mode
Short description

personal | professional | legal | official

Definition

The type of attestation the authenticator offers.

Requirements

Indicates the level of authority of the attestation.

Comments

While Composition.attester is not currently flagged as Must Support in PS-CA, Implementers who support attester are expected to support attester.mode, attester.time, and attester.party

Data type

code

Binding

The way in which a person authenticated a composition.

CompositionAttestationMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: unique(./modeCode)
  • cda: implied by .authenticator/.legalAuthenticator
timeS0..1dateTimeElement id
Composition.attester.time
Short description

When the composition was attested

Definition

When the composition was attested by the party.

Requirements

Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

Comments

While Composition.attester is not currently flagged as Must Support in PS-CA, Implementers who support attester are expected to support attester.mode, attester.time, and attester.party

Data type

dateTime

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./time[type="TS" and isNormalDatatype()]
  • cda: .authenticator.time
partyS0..1Reference(PatientPSCA | RelatedPerson | PractitionerProfile | PractitionerRoleProfile | OrganizationProfile)Element id
Composition.attester.party
Short description

Who attested the composition

Definition

Who attested the composition in the specified way.

Requirements

Identifies who has taken on the responsibility for accuracy of the composition content.

Comments

While Composition.attester is not currently flagged as Must Support in PS-CA, Implementers who support attester are expected to support attester.mode, attester.time, and attester.party

Data type

Reference(PatientPSCA | RelatedPerson | PractitionerProfile | PractitionerRoleProfile | OrganizationProfile)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.witness
  • rim: ./role[classCode="ASSIGNED" and isNormalRole]/player[determinerCode="INST" and classCode=("DEV", "PSN") and isNormalEntity()] or ./role[classCode="ASSIGNED" and isNormalRole and not(player)]/scoper[determinerCode="INST" and classCode="ORG" and isNormalEntity()]
  • cda: .authenticator.assignedEnttty
custodianS Σ0..1Reference(OrganizationProfile)Element id
Composition.custodian
Short description

Organization which maintains the composition

Definition

Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.

Requirements

Identifies where to go to find the current version, where to report issues, etc.

Comments

This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.

Data type

Reference(OrganizationProfile)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .participation[typeCode="RCV"].role[classCode="CUST"].scoper[classCode="ORG" and determinerCode="INST"]
  • cda: .custodian.assignedCustodian
  • fhirdocumentreference: DocumentReference.custodian
relatesTo0..*BackboneElement
There are no (further) constraints on this element
Element id
Composition.relatesTo
Short description

Relationships to other compositions/documents

Definition

Relationships that this composition has with other compositions or documents that already exist.

Comments

A document is a version specific composition.

Data type

BackboneElement

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship
  • cda: .relatedDocument
  • fhirdocumentreference: DocumentReference.relatesTo
id0..1string
There are no (further) constraints on this element
Element id
Composition.relatesTo.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.relatesTo.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.relatesTo.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
code1..1codeBinding
There are no (further) constraints on this element
Element id
Composition.relatesTo.code
Short description

replaces | transforms | signs | appends

Definition

The type of relationship that this composition has with anther composition or document.

Comments

If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.

Data type

code

Binding

The type of relationship between documents.

DocumentRelationshipType (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship.typeCode
  • cda: .relatedDocument.typeCode
  • fhirdocumentreference: DocumentReference.relatesTo.code
target[x]1..1
There are no (further) constraints on this element
Element id
Composition.relatesTo.target[x]
Short description

Target of the relationship

Definition

The target composition/document of this relationship.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .target[classCode="DOC", moodCode="EVN"].id
  • cda: .relatedDocument.id
  • fhirdocumentreference: DocumentReference.relatesTo.target
targetIdentifierIdentifierData type

Identifier

targetReferenceReference(Composition | CompositionPSCA)Data type

Reference(Composition | CompositionPSCA)

eventΣ0..*BackboneElementElement id
Composition.event
Short description

The clinical service(s) being documented

Definition

IPS Note: The main activity being described by a PS is the provision of healthcare over a period of time. In the CDA representation of the PS this is shown by setting the value of serviceEvent/@classCode to “PCPR” (care provision) and indicating the duration over which care was provided in serviceEvent/effectiveTime. In the FHIR representation at least one event should be used to record this information. Additional data from outside this duration may also be included if it is relevant to care provided during that time range (e.g., reviewed during the stated time range). For example if the PS is generated by a GP based on information recorded in his/her EHR-S, then the start value should represent the date when the treatment relationship between the patient and the GP started; and the end value the date of the latest care event.

Requirements

Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

Comments

The event needs to be consistent with the type element, though can provide further information if desired.

Data type

BackboneElement

Slicing

Unordered, Open, by code(Pattern)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: outboundRelationship[typeCode="SUBJ"].target[classCode<'ACT']
  • cda: .documentationOf.serviceEvent
  • fhirdocumentreference: DocumentReference.event
(All Slices)
The requirements in this element apply to all slices

id0..1string
There are no (further) constraints on this element
Element id
Composition.event.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.event.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.event.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
codeΣ0..*CodeableConcept
There are no (further) constraints on this element
Element id
Composition.event.code
Short description

Code(s) that apply to the event being documented

Definition

This 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.

Comments

An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.

Data type

CodeableConcept

Binding

This list of codes represents the main clinical acts being documented.

v3.ActCode (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .code
  • cda: .code
  • fhirdocumentreference: DocumentReference.event.code
periodΣ0..1Period
There are no (further) constraints on this element
Element id
Composition.event.period
Short description

The period covered by the documentation

Definition

The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.

Data type

Period

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .effectiveTime
  • cda: .effectiveTime
  • fhirdocumentreference: DocumentReference.event.period
detailΣ0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.event.detail
Short description

The event(s) being documented

Definition

The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode="SUBJ"].target
  • cda: n/a
careProvisioningEventΣ0..1BackboneElementElement id
Composition.event:careProvisioningEvent
Short description

The care provisioning being documented

Definition

The provision of healthcare over a period of time this PS is documented.

Requirements

Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

Comments

The event needs to be consistent with the type element, though can provide further information if desired.

Data type

BackboneElement

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: outboundRelationship[typeCode="SUBJ"].target[classCode<'ACT']
  • cda: .documentationOf.serviceEvent
  • fhirdocumentreference: DocumentReference.event
id0..1string
There are no (further) constraints on this element
Element id
Composition.event:careProvisioningEvent.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.event:careProvisioningEvent.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.event:careProvisioningEvent.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
codeS Σ1..*CodeableConceptPatternElement id
Composition.event:careProvisioningEvent.code
Short description

Code(s) that apply to the event being documented

Definition

This 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.

Comments

While Composition.event:careProvisioningEvent slice is not currently flagged as Must Support in PS-CA, Implementers who support the slice are expected to support Composition.event:careProvisioningEvent.code and Composition.event:careProvisioningEvent.period

Data type

CodeableConcept

Binding

This list of codes represents the main clinical acts being documented.

v3.ActCode (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v3-ActClass",
      "code": "PCPR"
    }
  ]
}
Mappings
  • rim: .code
  • cda: .code
  • fhirdocumentreference: DocumentReference.event.code
periodS Σ0..1PeriodElement id
Composition.event:careProvisioningEvent.period
Short description

The period covered by the documentation

Definition

The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.

Comments

While Composition.event:careProvisioningEvent slice is not currently flagged as Must Support in PS-CA, Implementers who support the slice are expected to support Composition.event:careProvisioningEvent.code and Composition.event:careProvisioningEvent.period

Data type

Period

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .effectiveTime
  • cda: .effectiveTime
  • fhirdocumentreference: DocumentReference.event.period
detailΣ0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.event:careProvisioningEvent.detail
Short description

The event(s) being documented

Definition

The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode="SUBJ"].target
  • cda: n/a
sectionS C1..*BackboneElementElement id
Composition.section
Short description

Sections composing the PS

Definition

The root of the sections that make up the PS-CA composition.

Data type

BackboneElement

Slicing

Unordered, Open, by code(Pattern)

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
(All Slices)
The requirements in this element apply to all slices

id0..1string
There are no (further) constraints on this element
Element id
Composition.section.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement id
Composition.section.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)Element id
Composition.section.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
title0..1string
There are no (further) constraints on this element
Element id
Composition.section.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConceptPSCAElement id
Composition.section.code
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

Provides computable standardized labels to topics within the document.

Comments

For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.

Data type

CodeableConceptPSCA

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./code
  • cda: .code
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textS C1..1NarrativeElement id
Composition.section.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryC0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section.entry
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..*see (section)
There are no (further) constraints on this element
Element id
Composition.section.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionMedicationsS C1..1BackboneElementElement id
Composition.section:sectionMedications
Short description

PS-CA Medication Summary Section

Definition

The medication summary section contains a description of the patient's medications relevant for the scope of the patient summary. The actual content could depend on the jurisdiction, it could report:

  • the currently active medications;
  • the current and past medications considered relevant by the authoring GP;
  • the patient prescriptions or dispensations automatically extracted by a regional or a national EHR.

Because This section has been expanded in the PS-CA to model a medicationRequest profile in addition to medicationStatement profile initially included in IPS-UV.

Comments

IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of data - though has recently updated to allow for the provision of section.emptyReason. This constraint has been maintained in the PS-CA. Systems should utilize the section.entry with a resource when conveying that the subject has no known medications (e.g., clinical assertions that are captured alongside supportive data like date). The section.emptyReason is available to convey details for why the section entry is empty (e.g., data unavailable).

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ips-comp-1: Either section.entry or emptyReason are present
    (entry.reference.exists() or emptyReason.exists())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement id
Composition.section:sectionMedications.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)Element id
Composition.section:sectionMedications.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1stringElement id
Composition.section:sectionMedications.title
Short description

Medication Summary section

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Medication Summary

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConcept, CodeableConceptPSCAPatternElement id
Composition.section:sectionMedications.code
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

Provides computable standardized labels to topics within the document.

Comments

For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.

Data type

CodeableConcept, CodeableConceptPSCA

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "10160-0"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textS C1..1NarrativeElement id
Composition.section:sectionMedications.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)Element id
Composition.section:sectionMedications.entry
Short description

Medications relevant for the scope of the patient summary

Definition

This list the medications relevant for the scope of the patient summary or it is used to indicate that the subject is known not to be on any relevant medication

Comments

This entry requires a medicationStatement or a medicationRequest.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
medicationStatementC0..*Reference(MedicationStatementPSCA)Element id
Composition.section:sectionMedications.entry:medicationStatement
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(MedicationStatementPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
medicationRequestC0..*Reference(MedicationRequestPSCA)Element id
Composition.section:sectionMedications.entry:medicationRequest
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(MedicationRequestPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonS C0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionAllergiesS C1..1BackboneElementElement id
Composition.section:sectionAllergies
Short description

PS-CA Allergies and Intolerances Section

Definition

This section documents the relevant allergies or intolerances (conditions) for that patient, describing the kind of reaction (e.g., rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. If no information about allergies is available, or if no allergies are known this should be clearly documented in the section.

Comments

IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of data - though has recently updated to allow for the provision of section.emptyReason. This constraint has been maintained in the PS-CA. Systems should utilize the section.entry with a resource when conveying that the subject has no known allergies (e.g., clinical assertions that are captured alongside supportive data like date). The section.emptyReason is available to convey details for why the section entry is empty (e.g., data unavailable).

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ips-comp-1: Either section.entry or emptyReason are present
    (entry.reference.exists() or emptyReason.exists())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement id
Composition.section:sectionAllergies.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)Element id
Composition.section:sectionAllergies.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1stringElement id
Composition.section:sectionAllergies.title
Short description

Allergies and Intolerances

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConcept, CodeableConceptPSCAPatternElement id
Composition.section:sectionAllergies.code
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

Provides computable standardized labels to topics within the document.

Comments

For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.

Data type

CodeableConcept, CodeableConceptPSCA

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "48765-2"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textS C1..1NarrativeElement id
Composition.section:sectionAllergies.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)Element id
Composition.section:sectionAllergies.entry
Short description

Relevant allergies or intolerances (conditions) for that patient.

Definition

It lists the relevant allergies or intolerances (conditions) for that patient, describing the kind of reaction (e.g., rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
allergyOrIntoleranceC0..*Reference(AllergyIntolerancePSCA)Element id
Composition.section:sectionAllergies.entry:allergyOrIntolerance
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(AllergyIntolerancePSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonS C0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionProblemsS C1..1BackboneElementElement id
Composition.section:sectionProblems
Short description

PS-CA Problems Section

Definition

The PS problem section lists and describes clinical problems or conditions currently being monitored for the patient.

Comments

IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of data - though has recently updated to allow for the provision of section.emptyReason. This constraint has been maintained in the PS-CA. Systems should utilize the section.entry with a resource when conveying that the subject has no known conditions (e.g., clinical assertions that are captured alongside supportive data like date). The section.emptyReason is available to convey details for why the section entry is empty (e.g., data unavailable).

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ips-comp-1: Either section.entry or emptyReason are present
    (entry.reference.exists() or emptyReason.exists())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement id
Composition.section:sectionProblems.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)Element id
Composition.section:sectionProblems.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConcept, CodeableConceptPSCAPatternElement id
Composition.section:sectionProblems.code
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

Provides computable standardized labels to topics within the document.

Comments

For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.

Data type

CodeableConcept, CodeableConceptPSCA

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "11450-4"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textS C1..1NarrativeElement id
Composition.section:sectionProblems.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)Element id
Composition.section:sectionProblems.entry
Short description

Clinical problems or conditions currently being monitored for the patient.

Definition

It lists and describes clinical problems or conditions currently being monitored for the patient.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
problemC0..*Reference(ConditionPSCA)Element id
Composition.section:sectionProblems.entry:problem
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ConditionPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonS C0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionProceduresHxC0..1BackboneElementElement id
Composition.section:sectionProceduresHx
Short description

PS-CA History of Procedures Section

Definition

The History of Procedures Section contains a description of the patient past procedures that are pertinent to the scope of this document. Procedures may refer for example to:

  1. Invasive Diagnostic procedure: e.g., Cardiac catheterization; (the results of these procedure are documented in the results section)
  2. Therapeutic procedure: e.g., dialysis;
  3. Surgical procedure: e.g., appendectomy
Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement id
Composition.section:sectionProceduresHx.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)Element id
Composition.section:sectionProceduresHx.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConcept, CodeableConceptPSCAPatternElement id
Composition.section:sectionProceduresHx.code
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

Provides computable standardized labels to topics within the document.

Comments

For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.

Data type

CodeableConcept, CodeableConceptPSCA

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "47519-4"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textS C1..1NarrativeElement id
Composition.section:sectionProceduresHx.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)Element id
Composition.section:sectionProceduresHx.entry
Short description

Patient past procedures pertinent to the scope of this document.

Definition

It lists the patient past procedures that are pertinent to the scope of this document. Procedures may refer for example to:

  1. Invasive Diagnostic procedure: e.g., Cardiac catheterization; (the results of these procedure are documented in the results section)
  2. Therapeutic procedure: e.g., dialysis;
  3. Surgical procedure: e.g., appendectomy.
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
procedureS C0..*Reference(ProcedurePSCA)Element id
Composition.section:sectionProceduresHx.entry:procedure
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ProcedurePSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionImmunizationsC0..1BackboneElementElement id
Composition.section:sectionImmunizations
Short description

PS-CA Immunizations Section

Definition

The Immunizations Section defines a patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. The section includes the current immunization status, and may contain the entire immunization history that is relevant to the period of time being summarized.

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement id
Composition.section:sectionImmunizations.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)Element id
Composition.section:sectionImmunizations.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConcept, CodeableConceptPSCAPatternElement id
Composition.section:sectionImmunizations.code
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

Provides computable standardized labels to topics within the document.

Comments

For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.

Data type

CodeableConcept, CodeableConceptPSCA

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "11369-6"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textS C1..1NarrativeElement id
Composition.section:sectionImmunizations.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)Element id
Composition.section:sectionImmunizations.entry
Short description

Patient's immunization status and pertinent history.

Definition

It defines the patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. It may contain the entire immunization history that is relevant to the period of time being summarized.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
immunizationS C0..*Reference(ImmunizationPSCA)Element id
Composition.section:sectionImmunizations.entry:immunization
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ImmunizationPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionMedicalDevicesC0..1BackboneElementElement id
Composition.section:sectionMedicalDevices
Short description

PS-CA Medical Devices Section

Definition

The medical devices section contains narrative text and coded entries describing the patient history of medical device use.

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries, future releases may further constrain this section as more jurisdictions look to support its use

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement id
Composition.section:sectionMedicalDevices.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)Element id
Composition.section:sectionMedicalDevices.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConcept, CodeableConceptPSCAPatternElement id
Composition.section:sectionMedicalDevices.code
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

Provides computable standardized labels to topics within the document.

Comments

For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.

Data type

CodeableConcept, CodeableConceptPSCA

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "46264-8"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textS C1..1NarrativeElement id
Composition.section:sectionMedicalDevices.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)Element id
Composition.section:sectionMedicalDevices.entry
Short description

Patient history of medical device use.

Definition

It describes the patient history of medical device use. This entry shall be used to document that no information about medical device use is available, or that no relevant medical device use is known.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
deviceStatementS C0..*Reference(DeviceUseStatementUvIps)Element id
Composition.section:sectionMedicalDevices.entry:deviceStatement
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

Pending definition of a PS CA device use section profile in a future release of PS CA, implementors are encouraged to use the IPS device use section profile.

Data type

Reference(DeviceUseStatementUvIps)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionResultsC0..1BackboneElementElement id
Composition.section:sectionResults
Short description

PS-CA Results Section

Definition

This section assembles relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. Some of these results may be laboratory results, others may be anatomic pathology results, others, radiology results, and others, clinical results.

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement id
Composition.section:sectionResults.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)Element id
Composition.section:sectionResults.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConcept, CodeableConceptPSCAPatternElement id
Composition.section:sectionResults.code
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

Provides computable standardized labels to topics within the document.

Comments

For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.

Data type

CodeableConcept, CodeableConceptPSCA

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "30954-2"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textS C1..1NarrativeElement id
Composition.section:sectionResults.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)Element id
Composition.section:sectionResults.entry
Short description

Relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient.

Definition

Relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. Some of these results may be laboratory results, others may be anatomic pathology results, others, radiology results, and others, clinical results.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
results-observation-laboratory-pathologyS C0..*Reference(ObservationResultsLaboratoryPathologyPSCA)Element id
Composition.section:sectionResults.entry:results-observation-laboratory-pathology
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ObservationResultsLaboratoryPathologyPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
results-observation-radiologyS C0..*Reference(ObservationResultsRadiologyPSCA)Element id
Composition.section:sectionResults.entry:results-observation-radiology
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ObservationResultsRadiologyPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
results-diagnosticReportS C0..*Reference(DiagnosticReportPSCA)Element id
Composition.section:sectionResults.entry:results-diagnosticReport
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

Pending definition of a PS CA diagnostic report profile in a future release of PS CA, implementors are encouraged to use the IPS diagnostic report profile.

Data type

Reference(DiagnosticReportPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionVitalSignsC0..1BackboneElementElement id
Composition.section:sectionVitalSigns
Short description

PS-CA Vital Signs Section

Definition

The Vital signs section includes blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement id
Composition.section:sectionVitalSigns.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)Element id
Composition.section:sectionVitalSigns.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConcept, CodeableConceptPSCAPatternElement id
Composition.section:sectionVitalSigns.code
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

Provides computable standardized labels to topics within the document.

Comments

For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.

Data type

CodeableConcept, CodeableConceptPSCA

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "8716-3"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textS C1..1NarrativeElement id
Composition.section:sectionVitalSigns.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)Element id
Composition.section:sectionVitalSigns.entry
Short description

Notable vital signs or physical findings.

Definition

Notable vital signs or physical findings as: blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included

Comments

IPS-UV and PS-CA point to the parent vital signs profile (http://hl7.org/fhir/StructureDefinition/vitalsigns) in the base FHIR specification, it is up to the jurisdictions to select and support the individual vital sign profiles. However, to support implementers in validation - the individual vital signs profiles have been included as individual slices below. The parent vital signs profile has been removed as a slice to prevent examples from matching multiple slices.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
BMIC0..*Reference(observation-bmi)Element id
Composition.section:sectionVitalSigns.entry:BMI
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-bmi)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
BPC0..*Reference(observation-bp)Element id
Composition.section:sectionVitalSigns.entry:BP
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-bp)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
BodyHeightC0..*Reference(observation-bodyheight)Element id
Composition.section:sectionVitalSigns.entry:BodyHeight
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-bodyheight)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
BodyTempC0..*Reference(observation-bodytemp)Element id
Composition.section:sectionVitalSigns.entry:BodyTemp
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-bodytemp)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
BodyWeightC0..*Reference(observation-bodyweight)Element id
Composition.section:sectionVitalSigns.entry:BodyWeight
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-bodyweight)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
HeadCircumC0..*Reference(observation-headcircum)Element id
Composition.section:sectionVitalSigns.entry:HeadCircum
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-headcircum)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
HeartRateC0..*Reference(observation-heartrate)Element id
Composition.section:sectionVitalSigns.entry:HeartRate
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-heartrate)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
OxygenSatC0..*Reference(observation-oxygensat)Element id
Composition.section:sectionVitalSigns.entry:OxygenSat
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-oxygensat)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
RespRateC0..*Reference(observation-resprate)Element id
Composition.section:sectionVitalSigns.entry:RespRate
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-resprate)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
VitalsPanelC0..*Reference(observation-vitalspanel)Element id
Composition.section:sectionVitalSigns.entry:VitalsPanel
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-vitalspanel)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionPastIllnessHxC0..1BackboneElementElement id
Composition.section:sectionPastIllnessHx
Short description

PS-CA History of Past Illness Section

Definition

The History of Past Illness section contains a description of the conditions the patient suffered in the past.

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement id
Composition.section:sectionPastIllnessHx.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)Element id
Composition.section:sectionPastIllnessHx.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConcept, CodeableConceptPSCAPatternElement id
Composition.section:sectionPastIllnessHx.code
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

Provides computable standardized labels to topics within the document.

Comments

For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.

Data type

CodeableConcept, CodeableConceptPSCA

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "11348-0"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textS C1..1NarrativeElement id
Composition.section:sectionPastIllnessHx.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)Element id
Composition.section:sectionPastIllnessHx.entry
Short description

Conditions the patient suffered in the past.

Definition

It contains a description of the conditions the patient suffered in the past.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
pastProblemS C0..*Reference(ConditionPSCA)Element id
Composition.section:sectionPastIllnessHx.entry:pastProblem
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ConditionPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionFunctionalStatusC0..1BackboneElementElement id
Composition.section:sectionFunctionalStatus
Short description

PS-CA Functional Status

Definition

The functional status section shall contain a narrative description of capability of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide.

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error.

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement id
Composition.section:sectionFunctionalStatus.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)Element id
Composition.section:sectionFunctionalStatus.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConcept, CodeableConceptPSCAPatternElement id
Composition.section:sectionFunctionalStatus.code
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

Provides computable standardized labels to topics within the document.

Comments

For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.

Data type

CodeableConcept, CodeableConceptPSCA

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "47420-5"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textS C1..1NarrativeElement id
Composition.section:sectionFunctionalStatus.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)Element id
Composition.section:sectionFunctionalStatus.entry
Short description

Optional entry used to represent disabilities and functional assessments

Definition

It describes capabilities of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
disabilityS C0..*Reference(ConditionPSCA)Element id
Composition.section:sectionFunctionalStatus.entry:disability
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ConditionPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
functionalAssessmentS C0..*Reference(ClinicalImpression)Element id
Composition.section:sectionFunctionalStatus.entry:functionalAssessment
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ClinicalImpression)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionPlanOfCareC0..1BackboneElementElement id
Composition.section:sectionPlanOfCare
Short description

PS-CA Plan of Care Section

Definition

The plan of care section contains a narrative description of the expectations for care including proposals, goals, and order requests for monitoring, tracking, or improving the condition of the patient.

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error.

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement id
Composition.section:sectionPlanOfCare.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)Element id
Composition.section:sectionPlanOfCare.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConcept, CodeableConceptPSCAPatternElement id
Composition.section:sectionPlanOfCare.code
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

Provides computable standardized labels to topics within the document.

Comments

For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.

Data type

CodeableConcept, CodeableConceptPSCA

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "18776-5"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textS C1..1NarrativeElement id
Composition.section:sectionPlanOfCare.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)Element id
Composition.section:sectionPlanOfCare.entry
Short description

Optional entry used to represent structured care plans

Definition

Dynamic, personalized plan including identified needed healthcare activity, health objectives and healthcare goals, relating to one or more specified health issues in a healthcare process [Source EN ISO 13940]

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
carePlanC0..*Reference(CarePlan)Element id
Composition.section:sectionPlanOfCare.entry:carePlan
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(CarePlan)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
documentReferenceC0..*Reference(DocumentReference)Element id
Composition.section:sectionPlanOfCare.entry:documentReference
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(DocumentReference)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionSocialHistoryC0..1BackboneElementElement id
Composition.section:sectionSocialHistory
Short description

PS-CA Social History Section

Definition

The social history section contains a description of the person’s Health related "lifestyle factors" or "lifestyle observations" (e.g., smoke habits; alcohol consumption; diets, risky habits.)

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement id
Composition.section:sectionSocialHistory.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)Element id
Composition.section:sectionSocialHistory.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConcept, CodeableConceptPSCAPatternElement id
Composition.section:sectionSocialHistory.code
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

Provides computable standardized labels to topics within the document.

Comments

For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.

Data type

CodeableConcept, CodeableConceptPSCA

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "29762-2"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textS C1..1NarrativeElement id
Composition.section:sectionSocialHistory.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)Element id
Composition.section:sectionSocialHistory.entry
Short description

Health related "lifestyle factors" or "lifestyle observations" (e.g., smoke habits; alcohol consumption; diets, risky habits.)

Definition

Description of the person’s Health related “lifestyle factors" or "lifestyle observations" (e.g., smoke habits; alcohol consumption; diets, risky habits.)

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
generalSocialHistoryC0..*Reference(ObservationSocialHistoryPSCA)Element id
Composition.section:sectionSocialHistory.entry:generalSocialHistory
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ObservationSocialHistoryPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
smokingTobaccoUseC0..1Reference(ObservationTobaccoUsePSCA)Element id
Composition.section:sectionSocialHistory.entry:smokingTobaccoUse
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ObservationTobaccoUsePSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
alcoholUseC0..1Reference(ObservationAlcoholUsePSCA)Element id
Composition.section:sectionSocialHistory.entry:alcoholUse
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ObservationAlcoholUsePSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionPregnancyHxC0..1BackboneElementElement id
Composition.section:sectionPregnancyHx
Short description

PS-CA History of Pregnancy Section

Definition

The history of pregnancy section shall contain information about whether the patient is currently pregnant or not. It may contain addition summarizing information about the outcome of earlier pregnancies.

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error.

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement id
Composition.section:sectionPregnancyHx.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)Element id
Composition.section:sectionPregnancyHx.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConcept, CodeableConceptPSCAPatternElement id
Composition.section:sectionPregnancyHx.code
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

Provides computable standardized labels to topics within the document.

Comments

For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.

Data type

CodeableConcept, CodeableConceptPSCA

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "10162-6"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textS C1..1NarrativeElement id
Composition.section:sectionPregnancyHx.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)Element id
Composition.section:sectionPregnancyHx.entry
Short description

Current pregnancy status and, optionally, information about the outcome of earlier pregnancies.

Definition

It contains information about whether the patient is currently pregnant or not. It may contain addition summarizing information about the outcome of earlier pregnancies.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
pregnancyStatusS C0..*Reference(ObservationPregnancyStatusUvIps)Element id
Composition.section:sectionPregnancyHx.entry:pregnancyStatus
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

Pending definition of a PS CA pregnancy status observation profile in a future release of PS CA, implementors are encouraged to use the IPS pregnancy status observation profile.

Data type

Reference(ObservationPregnancyStatusUvIps)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
pregnancyOutcomeSummaryS C0..*Reference(ObservationPregnancyOutcomeUvIps)Element id
Composition.section:sectionPregnancyHx.entry:pregnancyOutcomeSummary
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

Pending definition of a PS CA pregnancy outcome observation profile in a future release of PS CA, implementors are encouraged to use the IPS pregnancy outcome observation profile.

Data type

Reference(ObservationPregnancyOutcomeUvIps)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionAdvanceDirectivesC0..1BackboneElementElement id
Composition.section:sectionAdvanceDirectives
Short description

PS-CA Advance Directives Section

Definition

The advance directives section contains a narrative description of patient's advance directive.

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries.

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement id
Composition.section:sectionAdvanceDirectives.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)Element id
Composition.section:sectionAdvanceDirectives.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConcept, CodeableConceptPSCAPatternElement id
Composition.section:sectionAdvanceDirectives.code
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

Provides computable standardized labels to topics within the document.

Comments

For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.

Data type

CodeableConcept, CodeableConceptPSCA

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "42348-3"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textS C1..1NarrativeElement id
Composition.section:sectionAdvanceDirectives.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)Element id
Composition.section:sectionAdvanceDirectives.entry
Short description

Narrative description of the patient's advance directive.

Definition

Contains a narrative description or a Consent entry with information about the patient's advance directive.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
advanceDirectivesConsentC0..*Reference(Consent)Element id
Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Consent)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
advanceDirectivesDocumentReferenceC0..*Reference(DocumentReference)Element id
Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesDocumentReference
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(DocumentReference)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionFamilyHistoryC0..1BackboneElementElement id
Composition.section:sectionFamilyHistory
Short description

PS-CA Family History Section

Definition

The family history section contains a description of the patient's family history.

Comments

This is a new section being introduced by the PS-CA specification at the request of jurisdictions.

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement id
Composition.section:sectionFamilyHistory.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)Element id
Composition.section:sectionFamilyHistory.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConcept, CodeableConceptPSCAPatternElement id
Composition.section:sectionFamilyHistory.code
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

Provides computable standardized labels to topics within the document.

Comments

For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.

Data type

CodeableConcept, CodeableConceptPSCA

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "10157-6"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textS C1..1NarrativeElement id
Composition.section:sectionFamilyHistory.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)Element id
Composition.section:sectionFamilyHistory.entry
Short description

Narrative description of the patient's family history.

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
FamilyMemberHistoryS C0..*Reference(FamilyMemberHistoryPSCA)Element id
Composition.section:sectionFamilyHistory.entry:FamilyMemberHistory
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(FamilyMemberHistoryPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionPatientStoryC0..1BackboneElementElement id
Composition.section:sectionPatientStory
Short description

PS-CA Patient Story Section

Definition

The section contains narrative text along with optional resources that express what matters to a patient. This may include needs, strengths, values, concerns and preferences to others providing support and care. The patient’s story, provided here, may be told by the patient or by a proxy.

Comments

This is a new section being introduced by the PS-CA specification at the request of jurisdictions. While the Patient Story section is relatively unconstrained at this time, information that is better suited to another section should not be included in the Patient Story. For example, DNR orders should be placed in the Advanced Directives section.

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*ExtensionElement id
Composition.section:sectionPatientStory.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)Element id
Composition.section:sectionPatientStory.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConcept, CodeableConceptPSCAPatternElement id
Composition.section:sectionPatientStory.code
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

Provides computable standardized labels to topics within the document.

Comments

For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.

Data type

CodeableConcept, CodeableConceptPSCA

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "81338-6"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textS C1..1NarrativeElement id
Composition.section:sectionPatientStory.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryC0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.entry
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..*see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
CompositionPSCA (Composition)CComposition
There are no (further) constraints on this element
Element id
Composition
Short description

Canadian Patient Summary composition

Definition

Canadian Patient Summary composition. A composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained.

Comments

While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

Data type

Composition

Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
Mappings
  • rim: Entity. Role, or Act
  • workflow: Event
  • rim: Document[classCode="DOC" and moodCode="EVN" and isNormalAct()]
  • cda: ClinicalDocument
  • fhirdocumentreference: when described by DocumentReference
idΣ0..1string
There are no (further) constraints on this element
Element id
Composition.id
Short description

Logical id of this artifact

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Comments

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

Data type

string

metaΣ0..1Meta
There are no (further) constraints on this element
Element id
Composition.meta
Short description

Metadata about the resource

Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Data type

Meta

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
implicitRulesΣ ?!0..1uri
There are no (further) constraints on this element
Element id
Composition.implicitRules
Short description

A set of rules under which this content was created

Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
language0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.language
Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

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

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions
maxValueSetAllLanguages
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
textS0..1Narrative
There are no (further) constraints on this element
Element id
Composition.text
Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: Act.text?
contained0..*Resource
There are no (further) constraints on this element
Element id
Composition.contained
Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Data type

Resource

Mappings
  • rim: N/A
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
modifierExtension?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.modifierExtension
Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
identifierS Σ0..1Identifier
There are no (further) constraints on this element
Element id
Composition.identifier
Short description

Version-independent identifier for the Composition

Definition

A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

Comments

Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

Data type

Identifier

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.identifier
  • w5: FiveWs.identifier
  • rim: Document.id / Document.setId
  • cda: .setId
  • fhirdocumentreference: DocumentReference.masterIdentifier
statusS Σ ?!1..1codeBinding
There are no (further) constraints on this element
Element id
Composition.status
Short description

preliminary | final | amended | entered-in-error

Definition

The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

Requirements

Need to be able to mark interim, amended, or withdrawn compositions or documents.

Comments

If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements.

Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.

Data type

code

Binding

The workflow/clinical status of the composition.

CompositionStatus (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.status
  • w5: FiveWs.status
  • 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("ReviseComposition", code) and isNormalAct()]); amended: .completionCode="AU" && ./statusCode[isNormalDatatype()]="complete" and ./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[subsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("ReviseComposition", code) and isNormalAct() and statusCode="completed"]; withdrawn : .completionCode=NI && ./statusCode[isNormalDatatype()]="obsolete"
  • cda: n/a
  • fhirdocumentreference: DocumentReference.status
typeS Σ1..1CodeableConceptBindingPattern
There are no (further) constraints on this element
Element id
Composition.type
Short description

Kind of composition ("Patient Summary")

Definition

Specifies that this composition refers to a Patient Summary (Loinc "60591-5")

Requirements

Key metadata element describing the composition, used in searching/filtering.

Comments

For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

Data type

CodeableConcept

Binding

Type of a composition.

FHIRDocumentTypeCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "60591-5"
    }
  ]
}
Mappings
  • workflow: Event.code
  • w5: FiveWs.class
  • rim: ./code
  • cda: .code
  • fhirdocumentreference: DocumentReference.type
categoryΣ0..*CodeableConcept
There are no (further) constraints on this element
Element id
Composition.category
Short description

Categorization of Composition

Definition

A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.

Requirements

Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.

Comments

This is a metadata field from XDS/MHD.

Data type

CodeableConcept

Binding

High-level kind of a clinical document at a macro level.

DocumentClassValueSet (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.subject
  • w5: FiveWs.class
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
  • cda: n/a
  • fhirdocumentreference: DocumenttReference.category
subjectS Σ1..1Reference(PatientPSCA)
There are no (further) constraints on this element
Element id
Composition.subject
Short description

Who and/or what the composition is about

Definition

Who or what the composition is about. In general a composition 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 livestock, or a set of patients that share a common exposure). For the PS the subject is always the patient.

Requirements

Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.

Comments

For clinical documents, this is usually the patient.

Data type

Reference(PatientPSCA)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.subject[x]
  • rim: .participation[typeCode="SBJ"].role[typeCode="PAT"]
  • cda: .recordTarget
  • fhirdocumentreference: DocumentReference.subject
  • w5: FiveWs.subject
id0..1string
There are no (further) constraints on this element
Element id
Composition.subject.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.subject.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
referenceS Σ C1..1string
There are no (further) constraints on this element
Element id
Composition.subject.reference
Short description

Literal reference, Relative, internal or absolute URL

Definition

A 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.

Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
typeΣ0..1uriBinding
There are no (further) constraints on this element
Element id
Composition.subject.type
Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Data type

uri

Binding

Aa resource (or, for logical models, the URI of the logical model).

ResourceType (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
identifierΣ0..1Identifier
There are no (further) constraints on this element
Element id
Composition.subject.identifier
Short description

Logical reference, when literal reference is not known

Definition

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Data type

Identifier

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .identifier
displayΣ0..1string
There are no (further) constraints on this element
Element id
Composition.subject.display
Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
encounterΣ0..1Reference(Encounter)
There are no (further) constraints on this element
Element id
Composition.encounter
Short description

Context of the Composition

Definition

Describes the clinical encounter or type of care this documentation is associated with.

Requirements

Provides context for the composition and supports searching.

Comments

While IPS-UV considers this a Must Support element, policy has not yet been developed in Canada confirming the expectations for when a patient summary is created (e.g., does it have to be created by a health professional or just validated, can it be automatically assembled, does it have to occur within an encounter, etc.). This relaxation does not exclude or prevent implementers from further defining how encounter is used in their implementation if their use case(s) rely on its presence.

Data type

Reference(Encounter)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.context
  • w5: FiveWs.context
  • rim: unique(highest(./outboundRelationship[typeCode="SUBJ" and isNormalActRelationship()], priorityNumber)/target[moodCode="EVN" and classCode=("ENC", "PCPR") and isNormalAct])
  • cda: .componentOf.encompassingEncounter
  • fhirdocumentreference: DocumentReference.context.encounter
dateS Σ1..1dateTime
There are no (further) constraints on this element
Element id
Composition.date
Short description

Composition editing time

Definition

The composition editing time, when the composition was last logically changed by the author.

Requirements

dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.

Comments

The Last Modified Date on the composition may be after the date of the document was attested without being changed.

Data type

dateTime

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.occurrence[x]
  • w5: FiveWs.done[x]
  • rim: .effectiveTime[type="TS"]
  • cda: .effectiveTime
  • fhirdocumentreference: DocumentReference.content.attachment.date, DocumentReference.created
authorS Σ1..*Reference(PractitionerProfile | PractitionerRoleProfile | Device | PatientPSCA | RelatedPerson | OrganizationProfile)
There are no (further) constraints on this element
Element id
Composition.author
Short description

Who and/or what authored the patient summary

Definition

Identifies who is responsible for the information in the patient summary, not necessarily who typed it in.

The type of author(s) contribute to determine the "nature"of the Patient Summary: e.g., a "human-curated" PS Vs. an "automatically generated" PS.

Requirements

Identifies who is responsible for the content.

Data type

Reference(PractitionerProfile | PractitionerRoleProfile | Device | PatientPSCA | RelatedPerson | OrganizationProfile)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.performer
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
  • fhirdocumentreference: DocumentReference.agent
titleS Σ1..1string
There are no (further) constraints on this element
Element id
Composition.title
Short description

CA Patient Summary

Definition

Official human-readable label for the composition.

For this document should be "CA Patient Summary" or any equivalent translation

Comments

For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
  • fhirdocumentreference: DocumentReference.description, DocumentReference.content.attachment.title
confidentialityΣ0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.confidentiality
Short description

As defined by affinity domain

Definition

The code specifying the level of confidentiality of the Composition.

Comments

The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.

Data type

code

Binding

Codes specifying the level of confidentiality of the composition.

v3.ConfidentialityClassification (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .confidentialityCode
  • cda: .confidentialityCode
  • fhirdocumentreference: DocumentReference.securityLabel
attester0..*BackboneElement
There are no (further) constraints on this element
Element id
Composition.attester
Short description

Attests to accuracy of composition

Definition

A participant who has attested to the accuracy of the composition/document.

Requirements

Identifies responsibility for the accuracy of the composition content.

Comments

IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported across workflows of Canadian jurisdictional implementers.

These challenges have been raised in IPS. Further assessment of jurisdictional use cases need to be explored by the Patient Summary Working Group before the constraint will be re-considered for inclusion

Data type

BackboneElement

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .participation[typeCode="AUTHEN"].role[classCode="ASSIGNED"]
  • cda: .authenticator/.legalAuthenticator
  • fhirdocumentreference: DocumentReference.authenticator
id0..1string
There are no (further) constraints on this element
Element id
Composition.attester.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.attester.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.attester.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
modeS1..1codeBinding
There are no (further) constraints on this element
Element id
Composition.attester.mode
Short description

personal | professional | legal | official

Definition

The type of attestation the authenticator offers.

Requirements

Indicates the level of authority of the attestation.

Comments

While Composition.attester is not currently flagged as Must Support in PS-CA, Implementers who support attester are expected to support attester.mode, attester.time, and attester.party

Data type

code

Binding

The way in which a person authenticated a composition.

CompositionAttestationMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: unique(./modeCode)
  • cda: implied by .authenticator/.legalAuthenticator
timeS0..1dateTime
There are no (further) constraints on this element
Element id
Composition.attester.time
Short description

When the composition was attested

Definition

When the composition was attested by the party.

Requirements

Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

Comments

While Composition.attester is not currently flagged as Must Support in PS-CA, Implementers who support attester are expected to support attester.mode, attester.time, and attester.party

Data type

dateTime

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./time[type="TS" and isNormalDatatype()]
  • cda: .authenticator.time
partyS0..1Reference(PatientPSCA | RelatedPerson | PractitionerProfile | PractitionerRoleProfile | OrganizationProfile)
There are no (further) constraints on this element
Element id
Composition.attester.party
Short description

Who attested the composition

Definition

Who attested the composition in the specified way.

Requirements

Identifies who has taken on the responsibility for accuracy of the composition content.

Comments

While Composition.attester is not currently flagged as Must Support in PS-CA, Implementers who support attester are expected to support attester.mode, attester.time, and attester.party

Data type

Reference(PatientPSCA | RelatedPerson | PractitionerProfile | PractitionerRoleProfile | OrganizationProfile)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.witness
  • rim: ./role[classCode="ASSIGNED" and isNormalRole]/player[determinerCode="INST" and classCode=("DEV", "PSN") and isNormalEntity()] or ./role[classCode="ASSIGNED" and isNormalRole and not(player)]/scoper[determinerCode="INST" and classCode="ORG" and isNormalEntity()]
  • cda: .authenticator.assignedEnttty
custodianS Σ0..1Reference(OrganizationProfile)
There are no (further) constraints on this element
Element id
Composition.custodian
Short description

Organization which maintains the composition

Definition

Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.

Requirements

Identifies where to go to find the current version, where to report issues, etc.

Comments

This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.

Data type

Reference(OrganizationProfile)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .participation[typeCode="RCV"].role[classCode="CUST"].scoper[classCode="ORG" and determinerCode="INST"]
  • cda: .custodian.assignedCustodian
  • fhirdocumentreference: DocumentReference.custodian
relatesTo0..*BackboneElement
There are no (further) constraints on this element
Element id
Composition.relatesTo
Short description

Relationships to other compositions/documents

Definition

Relationships that this composition has with other compositions or documents that already exist.

Comments

A document is a version specific composition.

Data type

BackboneElement

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship
  • cda: .relatedDocument
  • fhirdocumentreference: DocumentReference.relatesTo
id0..1string
There are no (further) constraints on this element
Element id
Composition.relatesTo.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.relatesTo.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.relatesTo.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
code1..1codeBinding
There are no (further) constraints on this element
Element id
Composition.relatesTo.code
Short description

replaces | transforms | signs | appends

Definition

The type of relationship that this composition has with anther composition or document.

Comments

If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.

Data type

code

Binding

The type of relationship between documents.

DocumentRelationshipType (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship.typeCode
  • cda: .relatedDocument.typeCode
  • fhirdocumentreference: DocumentReference.relatesTo.code
target[x]1..1
There are no (further) constraints on this element
Element id
Composition.relatesTo.target[x]
Short description

Target of the relationship

Definition

The target composition/document of this relationship.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .target[classCode="DOC", moodCode="EVN"].id
  • cda: .relatedDocument.id
  • fhirdocumentreference: DocumentReference.relatesTo.target
targetIdentifierIdentifier
There are no (further) constraints on this element
Data type

Identifier

targetReferenceReference(Composition | CompositionPSCA)
There are no (further) constraints on this element
Data type

Reference(Composition | CompositionPSCA)

eventΣ0..*BackboneElement
There are no (further) constraints on this element
Element id
Composition.event
Short description

The clinical service(s) being documented

Definition

IPS Note: The main activity being described by a PS is the provision of healthcare over a period of time. In the CDA representation of the PS this is shown by setting the value of serviceEvent/@classCode to “PCPR” (care provision) and indicating the duration over which care was provided in serviceEvent/effectiveTime. In the FHIR representation at least one event should be used to record this information. Additional data from outside this duration may also be included if it is relevant to care provided during that time range (e.g., reviewed during the stated time range). For example if the PS is generated by a GP based on information recorded in his/her EHR-S, then the start value should represent the date when the treatment relationship between the patient and the GP started; and the end value the date of the latest care event.

Requirements

Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

Comments

The event needs to be consistent with the type element, though can provide further information if desired.

Data type

BackboneElement

Slicing

Unordered, Open, by code(Pattern)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: outboundRelationship[typeCode="SUBJ"].target[classCode<'ACT']
  • cda: .documentationOf.serviceEvent
  • fhirdocumentreference: DocumentReference.event
(All Slices)
The requirements in this element apply to all slices

id0..1string
There are no (further) constraints on this element
Element id
Composition.event.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.event.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.event.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
codeΣ0..*CodeableConcept
There are no (further) constraints on this element
Element id
Composition.event.code
Short description

Code(s) that apply to the event being documented

Definition

This 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.

Comments

An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.

Data type

CodeableConcept

Binding

This list of codes represents the main clinical acts being documented.

v3.ActCode (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .code
  • cda: .code
  • fhirdocumentreference: DocumentReference.event.code
periodΣ0..1Period
There are no (further) constraints on this element
Element id
Composition.event.period
Short description

The period covered by the documentation

Definition

The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.

Data type

Period

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .effectiveTime
  • cda: .effectiveTime
  • fhirdocumentreference: DocumentReference.event.period
detailΣ0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.event.detail
Short description

The event(s) being documented

Definition

The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode="SUBJ"].target
  • cda: n/a
careProvisioningEventΣ0..1BackboneElement
There are no (further) constraints on this element
Element id
Composition.event:careProvisioningEvent
Short description

The care provisioning being documented

Definition

The provision of healthcare over a period of time this PS is documented.

Requirements

Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

Comments

The event needs to be consistent with the type element, though can provide further information if desired.

Data type

BackboneElement

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: outboundRelationship[typeCode="SUBJ"].target[classCode<'ACT']
  • cda: .documentationOf.serviceEvent
  • fhirdocumentreference: DocumentReference.event
id0..1string
There are no (further) constraints on this element
Element id
Composition.event:careProvisioningEvent.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.event:careProvisioningEvent.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.event:careProvisioningEvent.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
codeS Σ1..*CodeableConceptPattern
There are no (further) constraints on this element
Element id
Composition.event:careProvisioningEvent.code
Short description

Code(s) that apply to the event being documented

Definition

This 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.

Comments

While Composition.event:careProvisioningEvent slice is not currently flagged as Must Support in PS-CA, Implementers who support the slice are expected to support Composition.event:careProvisioningEvent.code and Composition.event:careProvisioningEvent.period

Data type

CodeableConcept

Binding

This list of codes represents the main clinical acts being documented.

v3.ActCode (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v3-ActClass",
      "code": "PCPR"
    }
  ]
}
Mappings
  • rim: .code
  • cda: .code
  • fhirdocumentreference: DocumentReference.event.code
periodS Σ0..1Period
There are no (further) constraints on this element
Element id
Composition.event:careProvisioningEvent.period
Short description

The period covered by the documentation

Definition

The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.

Comments

While Composition.event:careProvisioningEvent slice is not currently flagged as Must Support in PS-CA, Implementers who support the slice are expected to support Composition.event:careProvisioningEvent.code and Composition.event:careProvisioningEvent.period

Data type

Period

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .effectiveTime
  • cda: .effectiveTime
  • fhirdocumentreference: DocumentReference.event.period
detailΣ0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.event:careProvisioningEvent.detail
Short description

The event(s) being documented

Definition

The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode="SUBJ"].target
  • cda: n/a
sectionS C1..*BackboneElement
There are no (further) constraints on this element
Element id
Composition.section
Short description

Sections composing the PS

Definition

The root of the sections that make up the PS-CA composition.

Data type

BackboneElement

Slicing

Unordered, Open, by code(Pattern)

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
(All Slices)
The requirements in this element apply to all slices

id0..1string
There are no (further) constraints on this element
Element id
Composition.section.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.section.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)
There are no (further) constraints on this element
Element id
Composition.section.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
title0..1string
There are no (further) constraints on this element
Element id
Composition.section.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConceptPSCA
There are no (further) constraints on this element
Element id
Composition.section.code
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

Provides computable standardized labels to topics within the document.

Comments

For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.

Data type

CodeableConceptPSCA

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./code
  • cda: .code
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textS C1..1Narrative
There are no (further) constraints on this element
Element id
Composition.section.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryC0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section.entry
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..*see (section)
There are no (further) constraints on this element
Element id
Composition.section.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionMedicationsS C1..1BackboneElement
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications
Short description

PS-CA Medication Summary Section

Definition

The medication summary section contains a description of the patient's medications relevant for the scope of the patient summary. The actual content could depend on the jurisdiction, it could report:

  • the currently active medications;
  • the current and past medications considered relevant by the authoring GP;
  • the patient prescriptions or dispensations automatically extracted by a regional or a national EHR.

Because This section has been expanded in the PS-CA to model a medicationRequest profile in addition to medicationStatement profile initially included in IPS-UV.

Comments

IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of data - though has recently updated to allow for the provision of section.emptyReason. This constraint has been maintained in the PS-CA. Systems should utilize the section.entry with a resource when conveying that the subject has no known medications (e.g., clinical assertions that are captured alongside supportive data like date). The section.emptyReason is available to convey details for why the section entry is empty (e.g., data unavailable).

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ips-comp-1: Either section.entry or emptyReason are present
    (entry.reference.exists() or emptyReason.exists())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.title
Short description

Medication Summary section

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Medication Summary

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConceptPattern
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.code
Short description

Classification of section (recommended)

Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

Requirements

Provides computable standardized labels to topics within the document.

Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Data type

CodeableConcept

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "10160-0"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textC0..1Narrative
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.entry
Short description

Medications relevant for the scope of the patient summary

Definition

This list the medications relevant for the scope of the patient summary or it is used to indicate that the subject is known not to be on any relevant medication

Comments

This entry requires a medicationStatement or a medicationRequest.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
medicationStatementC0..*Reference(MedicationStatementPSCA)
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.entry:medicationStatement
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(MedicationStatementPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
medicationRequestC0..*Reference(MedicationRequestPSCA)
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.entry:medicationRequest
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(MedicationRequestPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonS C0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionMedications.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionAllergiesS C1..1BackboneElement
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies
Short description

PS-CA Allergies and Intolerances Section

Definition

This section documents the relevant allergies or intolerances (conditions) for that patient, describing the kind of reaction (e.g., rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. If no information about allergies is available, or if no allergies are known this should be clearly documented in the section.

Comments

IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of data - though has recently updated to allow for the provision of section.emptyReason. This constraint has been maintained in the PS-CA. Systems should utilize the section.entry with a resource when conveying that the subject has no known allergies (e.g., clinical assertions that are captured alongside supportive data like date). The section.emptyReason is available to convey details for why the section entry is empty (e.g., data unavailable).

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ips-comp-1: Either section.entry or emptyReason are present
    (entry.reference.exists() or emptyReason.exists())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.title
Short description

Allergies and Intolerances

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConceptPattern
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.code
Short description

Classification of section (recommended)

Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

Requirements

Provides computable standardized labels to topics within the document.

Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Data type

CodeableConcept

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "48765-2"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textC0..1Narrative
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.entry
Short description

Relevant allergies or intolerances (conditions) for that patient.

Definition

It lists the relevant allergies or intolerances (conditions) for that patient, describing the kind of reaction (e.g., rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
allergyOrIntoleranceC0..*Reference(AllergyIntolerancePSCA)
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.entry:allergyOrIntolerance
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(AllergyIntolerancePSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonS C0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionAllergies.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionProblemsS C1..1BackboneElement
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems
Short description

PS-CA Problems Section

Definition

The PS problem section lists and describes clinical problems or conditions currently being monitored for the patient.

Comments

IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of data - though has recently updated to allow for the provision of section.emptyReason. This constraint has been maintained in the PS-CA. Systems should utilize the section.entry with a resource when conveying that the subject has no known conditions (e.g., clinical assertions that are captured alongside supportive data like date). The section.emptyReason is available to convey details for why the section entry is empty (e.g., data unavailable).

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ips-comp-1: Either section.entry or emptyReason are present
    (entry.reference.exists() or emptyReason.exists())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConceptPattern
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.code
Short description

Classification of section (recommended)

Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

Requirements

Provides computable standardized labels to topics within the document.

Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Data type

CodeableConcept

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "11450-4"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textC0..1Narrative
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.entry
Short description

Clinical problems or conditions currently being monitored for the patient.

Definition

It lists and describes clinical problems or conditions currently being monitored for the patient.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
problemC0..*Reference(ConditionPSCA)
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.entry:problem
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ConditionPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonS C0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionProblems.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionProceduresHxC0..1BackboneElement
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx
Short description

PS-CA History of Procedures Section

Definition

The History of Procedures Section contains a description of the patient past procedures that are pertinent to the scope of this document. Procedures may refer for example to:

  1. Invasive Diagnostic procedure: e.g., Cardiac catheterization; (the results of these procedure are documented in the results section)
  2. Therapeutic procedure: e.g., dialysis;
  3. Surgical procedure: e.g., appendectomy
Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConceptPattern
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.code
Short description

Classification of section (recommended)

Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

Requirements

Provides computable standardized labels to topics within the document.

Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Data type

CodeableConcept

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "47519-4"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textC0..1Narrative
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.entry
Short description

Patient past procedures pertinent to the scope of this document.

Definition

It lists the patient past procedures that are pertinent to the scope of this document. Procedures may refer for example to:

  1. Invasive Diagnostic procedure: e.g., Cardiac catheterization; (the results of these procedure are documented in the results section)
  2. Therapeutic procedure: e.g., dialysis;
  3. Surgical procedure: e.g., appendectomy.
Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
procedureS C0..*Reference(ProcedurePSCA)
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.entry:procedure
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ProcedurePSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionProceduresHx.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionImmunizationsC0..1BackboneElement
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations
Short description

PS-CA Immunizations Section

Definition

The Immunizations Section defines a patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. The section includes the current immunization status, and may contain the entire immunization history that is relevant to the period of time being summarized.

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConceptPattern
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.code
Short description

Classification of section (recommended)

Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

Requirements

Provides computable standardized labels to topics within the document.

Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Data type

CodeableConcept

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "11369-6"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textC0..1Narrative
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.entry
Short description

Patient's immunization status and pertinent history.

Definition

It defines the patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. It may contain the entire immunization history that is relevant to the period of time being summarized.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
immunizationS C0..*Reference(ImmunizationPSCA)
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.entry:immunization
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ImmunizationPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionImmunizations.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionMedicalDevicesC0..1BackboneElement
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices
Short description

PS-CA Medical Devices Section

Definition

The medical devices section contains narrative text and coded entries describing the patient history of medical device use.

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries, future releases may further constrain this section as more jurisdictions look to support its use

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConceptPattern
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.code
Short description

Classification of section (recommended)

Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

Requirements

Provides computable standardized labels to topics within the document.

Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Data type

CodeableConcept

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "46264-8"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textC0..1Narrative
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.entry
Short description

Patient history of medical device use.

Definition

It describes the patient history of medical device use. This entry shall be used to document that no information about medical device use is available, or that no relevant medical device use is known.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
deviceStatementS C0..*Reference(DeviceUseStatementUvIps)
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.entry:deviceStatement
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

Pending definition of a PS CA device use section profile in a future release of PS CA, implementors are encouraged to use the IPS device use section profile.

Data type

Reference(DeviceUseStatementUvIps)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionMedicalDevices.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionResultsC0..1BackboneElement
There are no (further) constraints on this element
Element id
Composition.section:sectionResults
Short description

PS-CA Results Section

Definition

This section assembles relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. Some of these results may be laboratory results, others may be anatomic pathology results, others, radiology results, and others, clinical results.

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConceptPattern
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.code
Short description

Classification of section (recommended)

Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

Requirements

Provides computable standardized labels to topics within the document.

Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Data type

CodeableConcept

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "30954-2"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textC0..1Narrative
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.entry
Short description

Relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient.

Definition

Relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. Some of these results may be laboratory results, others may be anatomic pathology results, others, radiology results, and others, clinical results.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
results-observation-laboratory-pathologyS C0..*Reference(ObservationResultsLaboratoryPathologyPSCA)
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.entry:results-observation-laboratory-pathology
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ObservationResultsLaboratoryPathologyPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
results-observation-radiologyS C0..*Reference(ObservationResultsRadiologyPSCA)
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.entry:results-observation-radiology
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ObservationResultsRadiologyPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
results-diagnosticReportS C0..*Reference(DiagnosticReportPSCA)
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.entry:results-diagnosticReport
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

Pending definition of a PS CA diagnostic report profile in a future release of PS CA, implementors are encouraged to use the IPS diagnostic report profile.

Data type

Reference(DiagnosticReportPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionResults.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionVitalSignsC0..1BackboneElement
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns
Short description

PS-CA Vital Signs Section

Definition

The Vital signs section includes blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConceptPattern
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.code
Short description

Classification of section (recommended)

Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

Requirements

Provides computable standardized labels to topics within the document.

Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Data type

CodeableConcept

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "8716-3"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textC0..1Narrative
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.entry
Short description

Notable vital signs or physical findings.

Definition

Notable vital signs or physical findings as: blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included

Comments

IPS-UV and PS-CA point to the parent vital signs profile (http://hl7.org/fhir/StructureDefinition/vitalsigns) in the base FHIR specification, it is up to the jurisdictions to select and support the individual vital sign profiles. However, to support implementers in validation - the individual vital signs profiles have been included as individual slices below. The parent vital signs profile has been removed as a slice to prevent examples from matching multiple slices.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
BMIC0..*Reference(observation-bmi)
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.entry:BMI
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-bmi)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
BPC0..*Reference(observation-bp)
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.entry:BP
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-bp)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
BodyHeightC0..*Reference(observation-bodyheight)
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.entry:BodyHeight
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-bodyheight)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
BodyTempC0..*Reference(observation-bodytemp)
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.entry:BodyTemp
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-bodytemp)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
BodyWeightC0..*Reference(observation-bodyweight)
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.entry:BodyWeight
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-bodyweight)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
HeadCircumC0..*Reference(observation-headcircum)
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.entry:HeadCircum
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-headcircum)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
HeartRateC0..*Reference(observation-heartrate)
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.entry:HeartRate
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-heartrate)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
OxygenSatC0..*Reference(observation-oxygensat)
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.entry:OxygenSat
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-oxygensat)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
RespRateC0..*Reference(observation-resprate)
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.entry:RespRate
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-resprate)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
VitalsPanelC0..*Reference(observation-vitalspanel)
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.entry:VitalsPanel
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(observation-vitalspanel)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionVitalSigns.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionPastIllnessHxC0..1BackboneElement
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx
Short description

PS-CA History of Past Illness Section

Definition

The History of Past Illness section contains a description of the conditions the patient suffered in the past.

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConceptPattern
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.code
Short description

Classification of section (recommended)

Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

Requirements

Provides computable standardized labels to topics within the document.

Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Data type

CodeableConcept

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "11348-0"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textC0..1Narrative
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.entry
Short description

Conditions the patient suffered in the past.

Definition

It contains a description of the conditions the patient suffered in the past.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
pastProblemS C0..*Reference(ConditionPSCA)
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.entry:pastProblem
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ConditionPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionPastIllnessHx.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionFunctionalStatusC0..1BackboneElement
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus
Short description

PS-CA Functional Status

Definition

The functional status section shall contain a narrative description of capability of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide.

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error.

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConceptPattern
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.code
Short description

Classification of section (recommended)

Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

Requirements

Provides computable standardized labels to topics within the document.

Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Data type

CodeableConcept

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "47420-5"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textC0..1Narrative
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.entry
Short description

Optional entry used to represent disabilities and functional assessments

Definition

It describes capabilities of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
disabilityS C0..*Reference(ConditionPSCA)
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.entry:disability
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ConditionPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
functionalAssessmentS C0..*Reference(ClinicalImpression)
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.entry:functionalAssessment
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ClinicalImpression)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionFunctionalStatus.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionPlanOfCareC0..1BackboneElement
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare
Short description

PS-CA Plan of Care Section

Definition

The plan of care section contains a narrative description of the expectations for care including proposals, goals, and order requests for monitoring, tracking, or improving the condition of the patient.

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error.

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConceptPattern
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.code
Short description

Classification of section (recommended)

Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

Requirements

Provides computable standardized labels to topics within the document.

Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Data type

CodeableConcept

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "18776-5"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textC0..1Narrative
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.entry
Short description

Optional entry used to represent structured care plans

Definition

Dynamic, personalized plan including identified needed healthcare activity, health objectives and healthcare goals, relating to one or more specified health issues in a healthcare process [Source EN ISO 13940]

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
carePlanC0..*Reference(CarePlan)
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.entry:carePlan
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(CarePlan)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
documentReferenceC0..*Reference(DocumentReference)
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.entry:documentReference
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(DocumentReference)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionPlanOfCare.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionSocialHistoryC0..1BackboneElement
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory
Short description

PS-CA Social History Section

Definition

The social history section contains a description of the person’s Health related "lifestyle factors" or "lifestyle observations" (e.g., smoke habits; alcohol consumption; diets, risky habits.)

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConceptPattern
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.code
Short description

Classification of section (recommended)

Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

Requirements

Provides computable standardized labels to topics within the document.

Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Data type

CodeableConcept

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "29762-2"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textC0..1Narrative
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.entry
Short description

Health related "lifestyle factors" or "lifestyle observations" (e.g., smoke habits; alcohol consumption; diets, risky habits.)

Definition

Description of the person’s Health related “lifestyle factors" or "lifestyle observations" (e.g., smoke habits; alcohol consumption; diets, risky habits.)

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
generalSocialHistoryC0..*Reference(ObservationSocialHistoryPSCA)
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.entry:generalSocialHistory
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ObservationSocialHistoryPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
smokingTobaccoUseC0..1Reference(ObservationTobaccoUsePSCA)
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.entry:smokingTobaccoUse
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ObservationTobaccoUsePSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
alcoholUseC0..1Reference(ObservationAlcoholUsePSCA)
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.entry:alcoholUse
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(ObservationAlcoholUsePSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionSocialHistory.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionPregnancyHxC0..1BackboneElement
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx
Short description

PS-CA History of Pregnancy Section

Definition

The history of pregnancy section shall contain information about whether the patient is currently pregnant or not. It may contain addition summarizing information about the outcome of earlier pregnancies.

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error.

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConceptPattern
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.code
Short description

Classification of section (recommended)

Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

Requirements

Provides computable standardized labels to topics within the document.

Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Data type

CodeableConcept

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "10162-6"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textC0..1Narrative
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.entry
Short description

Current pregnancy status and, optionally, information about the outcome of earlier pregnancies.

Definition

It contains information about whether the patient is currently pregnant or not. It may contain addition summarizing information about the outcome of earlier pregnancies.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
pregnancyStatusS C0..*Reference(ObservationPregnancyStatusUvIps)
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.entry:pregnancyStatus
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

Pending definition of a PS CA pregnancy status observation profile in a future release of PS CA, implementors are encouraged to use the IPS pregnancy status observation profile.

Data type

Reference(ObservationPregnancyStatusUvIps)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
pregnancyOutcomeSummaryS C0..*Reference(ObservationPregnancyOutcomeUvIps)
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.entry:pregnancyOutcomeSummary
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

Pending definition of a PS CA pregnancy outcome observation profile in a future release of PS CA, implementors are encouraged to use the IPS pregnancy outcome observation profile.

Data type

Reference(ObservationPregnancyOutcomeUvIps)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionPregnancyHx.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionAdvanceDirectivesC0..1BackboneElement
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives
Short description

PS-CA Advance Directives Section

Definition

The advance directives section contains a narrative description of patient's advance directive.

Comments

IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries.

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConceptPattern
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.code
Short description

Classification of section (recommended)

Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

Requirements

Provides computable standardized labels to topics within the document.

Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Data type

CodeableConcept

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "42348-3"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textC0..1Narrative
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.entry
Short description

Narrative description of the patient's advance directive.

Definition

Contains a narrative description or a Consent entry with information about the patient's advance directive.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
advanceDirectivesConsentC0..*Reference(Consent)
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Consent)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
advanceDirectivesDocumentReferenceC0..*Reference(DocumentReference)
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesDocumentReference
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(DocumentReference)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionAdvanceDirectives.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionFamilyHistoryC0..1BackboneElement
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory
Short description

PS-CA Family History Section

Definition

The family history section contains a description of the patient's family history.

Comments

This is a new section being introduced by the PS-CA specification at the request of jurisdictions.

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConceptPattern
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.code
Short description

Classification of section (recommended)

Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

Requirements

Provides computable standardized labels to topics within the document.

Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Data type

CodeableConcept

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "10157-6"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textC0..1Narrative
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryS C0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.entry
Short description

Narrative description of the patient's family history.

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Slicing

Unordered, Open, by resolve()(Profile)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
FamilyMemberHistoryS C0..*Reference(FamilyMemberHistoryPSCA)
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.entry:FamilyMemberHistory
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(FamilyMemberHistoryPSCA)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..0see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionFamilyHistory.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
sectionPatientStoryC0..1BackboneElement
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory
Short description

PS-CA Patient Story Section

Definition

The section contains narrative text along with optional resources that express what matters to a patient. This may include needs, strengths, values, concerns and preferences to others providing support and care. The patient’s story, provided here, may be told by the patient or by a proxy.

Comments

This is a new section being introduced by the PS-CA specification at the request of jurisdictions. While the Patient Story section is relatively unconstrained at this time, information that is better suited to another section should not be included in the Patient Story. For example, DNR orders should be placed in the Advanced Directives section.

Data type

BackboneElement

Constraints
  • cmp-1: A section must contain at least one of text, entries, or sub-sections
    text.exists() or entry.exists() or section.exists()
  • cmp-2: A section can only have an emptyReason if it is empty
    emptyReason.empty() or entry.empty()
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.structuredBody.component.section
id0..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
section-noteC0..*Extension(Annotation)
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.extension:section-note
Short description

Additional notes that apply to the section (but not to specific resource).

Alternate names

extensions, user content

Definition

Additional notes that apply to the section (but not to specific resource).

Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Data type

Extension(Annotation)

Extension URL

http://hl7.org/fhir/StructureDefinition/note

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

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

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
titleS1..1string
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.title
Short description

Label for section (e.g. for ToC)

Alternate names

header, label, caption

Definition

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

Requirements

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Comments

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./title
  • cda: .title
codeS1..1CodeableConceptPattern
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.code
Short description

Classification of section (recommended)

Definition

A code identifying the kind of content contained within the section. This must be consistent with the section title.

Requirements

Provides computable standardized labels to topics within the document.

Comments

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Data type

CodeableConcept

Binding

Classification of a section of a composition/document.

DocumentSectionCodes (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "81338-6"
    }
  ]
}
Mappings
  • rim: ./code
  • cda: .code
author0..*Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.author
Short description

Who and/or what authored the section

Definition

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Requirements

Identifies who is responsible for the content.

Data type

Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.author
  • rim: .participation[typeCode="AUT"].role[classCode="ASSIGNED"]
  • cda: .author.assignedAuthor
focus0..1Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.focus
Short description

Who/what the section is about, when it is not about the subject of composition

Definition

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Comments

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • cda: .subject? (CDA did not differentiate between subject and focus)
textC0..1Narrative
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.text
Short description

Text summary of the section, for human interpretation

Definition

A human-readable narrative that contains the attested content of the section, 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.

Comments

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .text
  • cda: .text
mode0..1codeBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.mode
Short description

working | snapshot | changes

Definition

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Comments

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Data type

code

Binding

The processing mode that applies to this section.

ListMode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value
  • cda: n/a
orderedBy0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.orderedBy
Short description

Order of section entries

Definition

Specifies the order applied to the items in the section entries.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

CodeableConcept

Binding

What order applies to the items in the entry.

ListOrderCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1
  • cda: n/a
entryC0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.entry
Short description

A reference to data that supports this section

Definition

A reference to the actual resource from which the narrative in the section is derived.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
  • cda: .entry
emptyReasonC0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.emptyReason
Short description

Why the section is empty

Definition

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

CodeableConcept

Binding

If a section is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]
  • cda: n/a
sectionC0..*see (section)
There are no (further) constraints on this element
Element id
Composition.section:sectionPatientStory.section
Short description

Nested Section

Definition

A nested sub-section within this section.

Comments

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Conditions

The cardinality or value of this element may be affected by these constraints: cmp-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: ./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
  • cda: .component.section
<StructureDefinition xmlns="http://hl7.org/fhir">
<id value="composition-ca-ps" />
<url value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps" />
<name value="CompositionPSCA" />
<title value="Composition (PS-CA)" />
<status value="draft" />
<experimental value="false" />
<date value="2023-12-21T00:00:00-08:00" />
<description value="This profile represents the constraints applied to the Composition resource by the PS-CA project.\nA Canadian Patient Summary (PS-CA) document is an electronic health record extract containing essential healthcare information about a subject of care. It is informed by the IPS-UV Composition profile, but differs in its application of Must Support flags on some of the sections to allow for jurisdictional implementors flexibility in what sections systems Must Support in order to show conformance to their respective patient summaries.\nThe PS-CA dataset is minimal and non-exhaustive; specialty-agnostic and condition-independent; but still clinically relevant. It is informed by the requirements specified in EN 17269 and ISO/DIS 27269, it is designed for supporting the international use case scenario for ‘unplanned, cross border care’, but is also designed to support a variety of use cases for cross-jurisdiction exchange. It is intended to guide implementation nationally while ensuring international exchange of patient summaries is not impeded.\n\nThis profile is based on the ClinicalDocument profile from the base R4 FHIR standard." />
<copyright value="Copyright © 2024+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy)." />
<fhirVersion value="4.0.1" />
<kind value="resource" />
<abstract value="false" />
<type value="Composition" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Composition" />
<derivation value="constraint" />
<snapshot>
<element id="Composition">
<path value="Composition" />
<short value="Canadian Patient Summary composition" />
<definition value="Canadian Patient Summary composition.\nA composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement.\nWhile a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained." />
<comment value="While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition" />
<min value="0" />
<max value="*" />
</base>
<constraint>
<key value="dom-2" />
<severity value="error" />
<human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
<expression value="contained.contained.empty()" />
<xpath value="not(parent::f:contained and f:contained)" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<key value="dom-3" />
<severity value="error" />
<human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource" />
<expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()" />
<xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<key value="dom-4" />
<severity value="error" />
<human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
<expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
<xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<key value="dom-5" />
<severity value="error" />
<human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
<expression value="contained.meta.security.empty()" />
<xpath value="not(exists(f:contained/*/f:meta/f:security))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
<valueBoolean value="true" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." />
</extension>
<key value="dom-6" />
<severity value="warning" />
<human value="A resource should have narrative for robust management" />
<expression value="text.`div`.exists()" />
<xpath value="exists(f:text/h:div)" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="Entity. Role, or Act" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Document[classCode="DOC" and moodCode="EVN" and isNormalAct()]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="ClinicalDocument" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="when described by DocumentReference" />
</mapping>
</element>
<element id="Composition.id">
<path value="Composition.id" />
<short value="Logical id of this artifact" />
<definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
<comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="true" />
</element>
<element id="Composition.meta">
<path value="Composition.meta" />
<short value="Metadata about the resource" />
<definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.meta" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Meta" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
</element>
<element id="Composition.implicitRules">
<path value="Composition.implicitRules" />
<short value="A set of rules under which this content was created" />
<definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc." />
<comment value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.implicitRules" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation" />
<isSummary value="true" />
</element>
<element id="Composition.language">
<path value="Composition.language" />
<short value="Language of the resource content" />
<definition value="The base language in which the resource is written." />
<comment value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.language" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
<valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="Language" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
<valueBoolean value="true" />
</extension>
<strength value="preferred" />
<description value="A human language." />
<valueSet value="http://hl7.org/fhir/ValueSet/languages" />
</binding>
</element>
<element id="Composition.text">
<path value="Composition.text" />
<short value="Text summary of the resource, for human interpretation" />
<definition value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
<comment value="PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text." />
<alias value="narrative" />
<alias value="html" />
<alias value="xhtml" />
<alias value="display" />
<min value="0" />
<max value="1" />
<base>
<path value="DomainResource.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="Act.text?" />
</mapping>
</element>
<element id="Composition.contained">
<path value="Composition.contained" />
<short value="Contained, inline Resources" />
<definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope." />
<comment value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels." />
<alias value="inline resources" />
<alias value="anonymous resources" />
<alias value="contained resources" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.contained" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Resource" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.extension">
<path value="Composition.extension" />
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.modifierExtension">
<path value="Composition.modifierExtension" />
<short value="Extensions that cannot be ignored" />
<definition value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.identifier">
<path value="Composition.identifier" />
<short value="Version-independent identifier for the Composition" />
<definition value="A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time." />
<comment value="Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.identifier" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Identifier" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="workflow" />
<map value="Event.identifier" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.identifier" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Document.id / Document.setId" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".setId" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.masterIdentifier" />
</mapping>
</element>
<element id="Composition.status">
<path value="Composition.status" />
<short value="preliminary | final | amended | entered-in-error" />
<definition value="The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document." />
<comment value="If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements. \n\nSome reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required." />
<requirements value="Need to be able to mark interim, amended, or withdrawn compositions or documents." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.status" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="true" />
<isModifierReason value="This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CompositionStatus" />
</extension>
<strength value="required" />
<description value="The workflow/clinical status of the composition." />
<valueSet value="http://hl7.org/fhir/ValueSet/composition-status|4.0.1" />
</binding>
<mapping>
<identity value="workflow" />
<map value="Event.status" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.status" />
</mapping>
<mapping>
<identity value="rim" />
<map value="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("ReviseComposition", code) and isNormalAct()]); amended: .completionCode="AU" && ./statusCode[isNormalDatatype()]="complete" and ./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[subsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("ReviseComposition", code) and isNormalAct() and statusCode="completed"]; withdrawn : .completionCode=NI && ./statusCode[isNormalDatatype()]="obsolete"" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.status" />
</mapping>
</element>
<element id="Composition.type">
<path value="Composition.type" />
<short value="Kind of composition ("Patient Summary")" />
<definition value="Specifies that this composition refers to a Patient Summary (Loinc "60591-5")" />
<comment value="For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding." />
<requirements value="Key metadata element describing the composition, used in searching/filtering." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.type" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="60591-5" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="DocumentType" />
</extension>
<strength value="preferred" />
<description value="Type of a composition." />
<valueSet value="http://hl7.org/fhir/ValueSet/doc-typecodes" />
</binding>
<mapping>
<identity value="workflow" />
<map value="Event.code" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.type" />
</mapping>
</element>
<element id="Composition.category">
<path value="Composition.category" />
<short value="Categorization of Composition" />
<definition value="A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type." />
<comment value="This is a metadata field from [XDS/MHD](http://wiki.ihe.net/index.php?title=Mobile_access_to_Health_Documents_(MHD))." />
<requirements value="Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.category" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="DocumentCategory" />
</extension>
<strength value="example" />
<description value="High-level kind of a clinical document at a macro level." />
<valueSet value="http://hl7.org/fhir/ValueSet/document-classcodes" />
</binding>
<mapping>
<identity value="workflow" />
<map value="Event.subject" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumenttReference.category" />
</mapping>
</element>
<element id="Composition.subject">
<path value="Composition.subject" />
<short value="Who and/or what the composition is about" />
<definition value="Who or what the composition is about.\nIn general a composition 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 livestock, or a set of patients that share a common exposure).\nFor the PS the subject is always the patient." />
<comment value="For clinical documents, this is usually the patient." />
<requirements value="Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.subject" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="w5" />
<map value="FiveWs.subject[x]" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="SBJ"].role[typeCode="PAT"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".recordTarget" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.subject" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.subject" />
</mapping>
</element>
<element id="Composition.subject.id">
<path value="Composition.subject.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.subject.extension">
<path value="Composition.subject.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.subject.reference">
<path value="Composition.subject.reference" />
<short value="Literal reference, Relative, internal or absolute URL" />
<definition value="A 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." />
<comment value="Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server." />
<min value="1" />
<max value="1" />
<base>
<path value="Reference.reference" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ref-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.subject.type">
<path value="Composition.subject.type" />
<short value="Type the reference refers to (e.g. "Patient")" />
<definition value="The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources)." />
<comment value="This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified." />
<min value="0" />
<max value="1" />
<base>
<path value="Reference.type" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="FHIRResourceTypeExt" />
</extension>
<strength value="extensible" />
<description value="Aa resource (or, for logical models, the URI of the logical model)." />
<valueSet value="http://hl7.org/fhir/ValueSet/resource-types" />
</binding>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.subject.identifier">
<path value="Composition.subject.identifier" />
<short value="Logical reference, when literal reference is not known" />
<definition value="An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference." />
<comment value="When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen 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\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any)." />
<min value="0" />
<max value="1" />
<base>
<path value="Reference.identifier" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Identifier" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value=".identifier" />
</mapping>
</element>
<element id="Composition.subject.display">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="Composition.subject.display" />
<short value="Text alternative for the resource" />
<definition value="Plain text narrative that identifies the resource in addition to the resource reference." />
<comment value="This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it." />
<min value="0" />
<max value="1" />
<base>
<path value="Reference.display" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.encounter">
<path value="Composition.encounter" />
<short value="Context of the Composition" />
<definition value="Describes the clinical encounter or type of care this documentation is associated with." />
<comment value="While IPS-UV considers this a Must Support element, policy has not yet been developed in Canada confirming the expectations for when a patient summary is created (e.g., does it have to be created by a health professional or just validated, can it be automatically assembled, does it have to occur within an encounter, etc.). This relaxation does not exclude or prevent implementers from further defining how encounter is used in their implementation if their use case(s) rely on its presence." />
<requirements value="Provides context for the composition and supports searching." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.encounter" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="workflow" />
<map value="Event.context" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.context" />
</mapping>
<mapping>
<identity value="rim" />
<map value="unique(highest(./outboundRelationship[typeCode="SUBJ" and isNormalActRelationship()], priorityNumber)/target[moodCode="EVN" and classCode=("ENC", "PCPR") and isNormalAct])" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".componentOf.encompassingEncounter" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.context.encounter" />
</mapping>
</element>
<element id="Composition.date">
<path value="Composition.date" />
<short value="Composition editing time" />
<definition value="The composition editing time, when the composition was last logically changed by the author." />
<comment value="The Last Modified Date on the composition may be after the date of the document was attested without being changed." />
<requirements value="dateTime is used for tracking, organizing versions and searching. Note that this is the time of *authoring*. When packaged in a document, [Bundle.timestamp](bundle-definitions.html#Bundle.timestamp) is the date of packaging." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.date" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="dateTime" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="workflow" />
<map value="Event.occurrence[x]" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.done[x]" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".effectiveTime[type="TS"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".effectiveTime" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.content.attachment.date, DocumentReference.created" />
</mapping>
</element>
<element id="Composition.author">
<path value="Composition.author" />
<short value="Who and/or what authored the patient summary" />
<definition value="Identifies who is responsible for the information in the patient summary, not necessarily who typed it in.\n\nThe type of author(s) contribute to determine the "nature"of the Patient Summary: e.g., a "human-curated" PS Vs. an "automatically generated" PS." />
<requirements value="Identifies who is responsible for the content." />
<min value="1" />
<max value="*" />
<base>
<path value="Composition.author" />
<min value="1" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner" />
<targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="workflow" />
<map value="Event.performer" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".author.assignedAuthor" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.agent" />
</mapping>
</element>
<element id="Composition.title">
<path value="Composition.title" />
<short value="CA Patient Summary" />
<definition value="Official human-readable label for the composition.\n\nFor this document should be "CA Patient Summary" or any equivalent translation" />
<comment value="For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.title" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="./title" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".title" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.description, DocumentReference.content.attachment.title" />
</mapping>
</element>
<element id="Composition.confidentiality">
<path value="Composition.confidentiality" />
<short value="As defined by affinity domain" />
<definition value="The code specifying the level of confidentiality of the Composition." />
<comment value="The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.confidentiality" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="DocumentConfidentiality" />
</extension>
<strength value="required" />
<description value="Codes specifying the level of confidentiality of the composition." />
<valueSet value="http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26" />
</binding>
<mapping>
<identity value="rim" />
<map value=".confidentialityCode" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".confidentialityCode" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.securityLabel" />
</mapping>
</element>
<element id="Composition.attester">
<path value="Composition.attester" />
<short value="Attests to accuracy of composition" />
<definition value="A participant who has attested to the accuracy of the composition/document." />
<comment value="IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported across workflows of Canadian jurisdictional implementers. \n\n These challenges have been raised in IPS. Further assessment of jurisdictional use cases need to be explored by the Patient Summary Working Group before the constraint will be re-considered for inclusion" />
<requirements value="Identifies responsibility for the accuracy of the composition content." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.attester" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="AUTHEN"].role[classCode="ASSIGNED"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".authenticator/.legalAuthenticator" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.authenticator" />
</mapping>
</element>
<element id="Composition.attester.id">
<path value="Composition.attester.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.attester.extension">
<path value="Composition.attester.extension" />
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.attester.modifierExtension">
<path value="Composition.attester.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.attester.mode">
<path value="Composition.attester.mode" />
<short value="personal | professional | legal | official" />
<definition value="The type of attestation the authenticator offers." />
<comment value="While Composition.attester is not currently flagged as Must Support in PS-CA, Implementers who support attester are expected to support attester.mode, attester.time, and attester.party" />
<requirements value="Indicates the level of authority of the attestation." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.attester.mode" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CompositionAttestationMode" />
</extension>
<strength value="required" />
<description value="The way in which a person authenticated a composition." />
<valueSet value="http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1" />
</binding>
<mapping>
<identity value="rim" />
<map value="unique(./modeCode)" />
</mapping>
<mapping>
<identity value="cda" />
<map value="implied by .authenticator/.legalAuthenticator" />
</mapping>
</element>
<element id="Composition.attester.time">
<path value="Composition.attester.time" />
<short value="When the composition was attested" />
<definition value="When the composition was attested by the party." />
<comment value="While Composition.attester is not currently flagged as Must Support in PS-CA, Implementers who support attester are expected to support attester.mode, attester.time, and attester.party" />
<requirements value="Identifies when the information in the composition was deemed accurate. (Things may have changed since then.)." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.attester.time" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="dateTime" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./time[type="TS" and isNormalDatatype()]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".authenticator.time" />
</mapping>
</element>
<element id="Composition.attester.party">
<path value="Composition.attester.party" />
<short value="Who attested the composition" />
<definition value="Who attested the composition in the specified way." />
<comment value="While Composition.attester is not currently flagged as Must Support in PS-CA, Implementers who support attester are expected to support attester.mode, attester.time, and attester.party" />
<requirements value="Identifies who has taken on the responsibility for accuracy of the composition content." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.attester.party" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner" />
<targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole" />
<targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="w5" />
<map value="FiveWs.witness" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./role[classCode="ASSIGNED" and isNormalRole]/player[determinerCode="INST" and classCode=("DEV", "PSN") and isNormalEntity()] or ./role[classCode="ASSIGNED" and isNormalRole and not(player)]/scoper[determinerCode="INST" and classCode="ORG" and isNormalEntity()]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".authenticator.assignedEnttty" />
</mapping>
</element>
<element id="Composition.custodian">
<path value="Composition.custodian" />
<short value="Organization which maintains the composition" />
<definition value="Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information." />
<comment value="This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged." />
<requirements value="Identifies where to go to find the current version, where to report issues, etc." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.custodian" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="RCV"].role[classCode="CUST"].scoper[classCode="ORG" and determinerCode="INST"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".custodian.assignedCustodian" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.custodian" />
</mapping>
</element>
<element id="Composition.relatesTo">
<path value="Composition.relatesTo" />
<short value="Relationships to other compositions/documents" />
<definition value="Relationships that this composition has with other compositions or documents that already exist." />
<comment value="A document is a version specific composition." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.relatesTo" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".relatedDocument" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.relatesTo" />
</mapping>
</element>
<element id="Composition.relatesTo.id">
<path value="Composition.relatesTo.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.relatesTo.extension">
<path value="Composition.relatesTo.extension" />
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.relatesTo.modifierExtension">
<path value="Composition.relatesTo.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.relatesTo.code">
<path value="Composition.relatesTo.code" />
<short value="replaces | transforms | signs | appends" />
<definition value="The type of relationship that this composition has with anther composition or document." />
<comment value="If this document appends another document, then the document cannot be fully understood without also accessing the referenced document." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.relatesTo.code" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="DocumentRelationshipType" />
</extension>
<strength value="required" />
<description value="The type of relationship between documents." />
<valueSet value="http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1" />
</binding>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship.typeCode" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".relatedDocument.typeCode" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.relatesTo.code" />
</mapping>
</element>
<element id="Composition.relatesTo.target[x]">
<path value="Composition.relatesTo.target[x]" />
<short value="Target of the relationship" />
<definition value="The target composition/document of this relationship." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.relatesTo.target[x]" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="Identifier" />
</type>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Composition" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".target[classCode="DOC", moodCode="EVN"].id" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".relatedDocument.id" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.relatesTo.target" />
</mapping>
</element>
<element id="Composition.event">
<path value="Composition.event" />
<slicing>
<discriminator>
<type value="pattern" />
<path value="code" />
</discriminator>
<rules value="open" />
</slicing>
<short value="The clinical service(s) being documented" />
<definition value="IPS Note: The main activity being described by a PS is the provision of healthcare over a period of time. In the CDA representation of the PS this is shown by setting the value of serviceEvent/@classCode to “PCPR” (care provision) and indicating the duration over which care was provided in serviceEvent/effectiveTime. In the FHIR representation at least one event should be used to record this information. Additional data from outside this duration may also be included if it is relevant to care provided during that time range (e.g., reviewed during the stated time range). For example if the PS is generated by a GP based on information recorded in his/her EHR-S, then the start value should represent the date when the treatment relationship between the patient and the GP started; and the end value the date of the latest care event." />
<comment value="The event needs to be consistent with the type element, though can provide further information if desired." />
<requirements value="Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.event" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode="SUBJ"].target[classCode<'ACT']" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".documentationOf.serviceEvent" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.event" />
</mapping>
</element>
<element id="Composition.event.id">
<path value="Composition.event.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.event.extension">
<path value="Composition.event.extension" />
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.event.modifierExtension">
<path value="Composition.event.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.event.code">
<path value="Composition.event.code" />
<short value="Code(s) that apply to the event being documented" />
<definition value="This 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." />
<comment value="An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.event.code" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="DocumentEventType" />
</extension>
<strength value="example" />
<description value="This list of codes represents the main clinical acts being documented." />
<valueSet value="http://terminology.hl7.org/ValueSet/v3-ActCode" />
</binding>
<mapping>
<identity value="rim" />
<map value=".code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.event.code" />
</mapping>
</element>
<element id="Composition.event.period">
<path value="Composition.event.period" />
<short value="The period covered by the documentation" />
<definition value="The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.event.period" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Period" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value=".effectiveTime" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".effectiveTime" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.event.period" />
</mapping>
</element>
<element id="Composition.event.detail">
<path value="Composition.event.detail" />
<short value="The event(s) being documented" />
<definition value="The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.event.detail" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode="SUBJ"].target" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.event:careProvisioningEvent">
<path value="Composition.event" />
<sliceName value="careProvisioningEvent" />
<short value="The care provisioning being documented" />
<definition value="The provision of healthcare over a period of time this PS is documented." />
<comment value="The event needs to be consistent with the type element, though can provide further information if desired." />
<requirements value="Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.event" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode="SUBJ"].target[classCode<'ACT']" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".documentationOf.serviceEvent" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.event" />
</mapping>
</element>
<element id="Composition.event:careProvisioningEvent.id">
<path value="Composition.event.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.event:careProvisioningEvent.extension">
<path value="Composition.event.extension" />
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.event:careProvisioningEvent.modifierExtension">
<path value="Composition.event.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.event:careProvisioningEvent.code">
<path value="Composition.event.code" />
<short value="Code(s) that apply to the event being documented" />
<definition value="This 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." />
<comment value="While Composition.event:careProvisioningEvent slice is not currently flagged as Must Support in PS-CA, Implementers who support the slice are expected to support Composition.event:careProvisioningEvent.code and Composition.event:careProvisioningEvent.period" />
<min value="1" />
<max value="*" />
<base>
<path value="Composition.event.code" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActClass" />
<code value="PCPR" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="DocumentEventType" />
</extension>
<strength value="example" />
<description value="This list of codes represents the main clinical acts being documented." />
<valueSet value="http://terminology.hl7.org/ValueSet/v3-ActCode" />
</binding>
<mapping>
<identity value="rim" />
<map value=".code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.event.code" />
</mapping>
</element>
<element id="Composition.event:careProvisioningEvent.period">
<path value="Composition.event.period" />
<short value="The period covered by the documentation" />
<definition value="The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time." />
<comment value="While Composition.event:careProvisioningEvent slice is not currently flagged as Must Support in PS-CA, Implementers who support the slice are expected to support Composition.event:careProvisioningEvent.code and Composition.event:careProvisioningEvent.period" />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.event.period" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Period" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value=".effectiveTime" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".effectiveTime" />
</mapping>
<mapping>
<identity value="fhirdocumentreference" />
<map value="DocumentReference.event.period" />
</mapping>
</element>
<element id="Composition.event:careProvisioningEvent.detail">
<path value="Composition.event.detail" />
<short value="The event(s) being documented" />
<definition value="The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.event.detail" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode="SUBJ"].target" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<slicing>
<discriminator>
<type value="pattern" />
<path value="code" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Sections composing the PS" />
<definition value="The root of the sections that make up the PS-CA composition." />
<min value="1" />
<max value="*" />
<base>
<path value="Composition.section" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="cmp-1" />
<severity value="error" />
<human value="A section must contain at least one of text, entries, or sub-sections" />
<expression value="text.exists() or entry.exists() or section.exists()" />
<xpath value="exists(f:text) or exists(f:entry) or exists(f:section)" />
</constraint>
<constraint>
<key value="cmp-2" />
<severity value="error" />
<human value="A section can only have an emptyReason if it is empty" />
<expression value="emptyReason.empty() or entry.empty()" />
<xpath value="not(exists(f:emptyReason) and exists(f:entry))" />
</constraint>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.structuredBody.component.section" />
</mapping>
</element>
<element id="Composition.section.id">
<path value="Composition.section.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section.extension">
<path value="Composition.section.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<comment value="This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element" />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section.modifierExtension">
<path value="Composition.section.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.section.title">
<path value="Composition.section.title" />
<short value="Label for section (e.g. for ToC)" />
<definition value="The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents." />
<comment value="The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." />
<requirements value="Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized." />
<alias value="header" />
<alias value="label" />
<alias value="caption" />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.title" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./title" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".title" />
</mapping>
</element>
<element id="Composition.section.code">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
<valueCode value="normative" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
<valueCode value="4.0.0" />
</extension>
<path value="Composition.section.code" />
<short value="Concept - reference to a terminology or just text" />
<definition value="A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text." />
<comment value="For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text." />
<requirements value="Provides computable standardized labels to topics within the document." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
<profile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CompositionSectionType" />
</extension>
<strength value="example" />
<description value="Classification of a section of a composition/document." />
<valueSet value="http://hl7.org/fhir/ValueSet/doc-section-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
</element>
<element id="Composition.section.author">
<path value="Composition.section.author" />
<short value="Who and/or what authored the section" />
<definition value="Identifies who is responsible for the information in this section, not necessarily who typed it in." />
<requirements value="Identifies who is responsible for the content." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.author" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".author.assignedAuthor" />
</mapping>
</element>
<element id="Composition.section.focus">
<path value="Composition.section.focus" />
<short value="Who/what the section is about, when it is not about the subject of composition" />
<definition value="The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources)." />
<comment value="Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.focus" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="cda" />
<map value=".subject? (CDA did not differentiate between subject and focus)" />
</mapping>
</element>
<element id="Composition.section.text">
<path value="Composition.section.text" />
<short value="Text summary of the section, for human interpretation" />
<definition value="A human-readable narrative that contains the attested content of the section, 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." />
<comment value="PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".text" />
</mapping>
</element>
<element id="Composition.section.mode">
<path value="Composition.section.mode" />
<short value="working | snapshot | changes" />
<definition value="How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted." />
<comment value="This element is labeled as a modifier because a change list must not be misunderstood as a complete list." />
<requirements value="Sections are used in various ways, and it must be known in what way it is safe to use the entries in them." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.mode" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionMode" />
</extension>
<strength value="required" />
<description value="The processing mode that applies to this section." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-mode|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section.orderedBy">
<path value="Composition.section.orderedBy" />
<short value="Order of section entries" />
<definition value="Specifies the order applied to the items in the section entries." />
<comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order." />
<requirements value="Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.orderedBy" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEntryOrder" />
</extension>
<strength value="preferred" />
<description value="What order applies to the items in the entry." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-order" />
</binding>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP].sequenceNumber > 1" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section.entry">
<path value="Composition.section.entry" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section.emptyReason">
<path value="Composition.section.emptyReason" />
<short value="Why the section is empty" />
<definition value="If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason." />
<comment value="The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases." />
<requirements value="Allows capturing things like "none exist" or "not asked" which can be important for most lists." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEmptyReason" />
</extension>
<strength value="preferred" />
<description value="If a section is empty, why it is empty." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-empty-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section.section">
<path value="Composition.section.section" />
<short value="Nested Section" />
<definition value="A nested sub-section within this section." />
<comment value="Nested sections are primarily used to help human readers navigate to particular portions of the document." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.section" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" />
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.section" />
</mapping>
</element>
<element id="Composition.section:sectionMedications">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionMedications" />
<short value="PS-CA Medication Summary Section" />
<definition value="The medication summary section contains a description of the patient's medications relevant for the scope of the patient summary. The actual content could depend on the jurisdiction, it could report:\n- the currently active medications;\n- the current and past medications considered relevant by the authoring GP;\n- the patient prescriptions or dispensations automatically extracted by a regional or a national EHR.\n\nBecause This section has been expanded in the PS-CA to model a medicationRequest profile in addition to medicationStatement profile initially included in IPS-UV." />
<comment value="IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of data - though has recently updated to allow for the provision of section.emptyReason. This constraint has been maintained in the PS-CA. Systems should utilize the section.entry with a resource when conveying that the subject has no known medications (e.g., clinical assertions that are captured alongside supportive data like date). The section.emptyReason is available to convey details for why the section entry is empty (e.g., data unavailable)." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="cmp-1" />
<severity value="error" />
<human value="A section must contain at least one of text, entries, or sub-sections" />
<expression value="text.exists() or entry.exists() or section.exists()" />
<xpath value="exists(f:text) or exists(f:entry) or exists(f:section)" />
<source value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps" />
</constraint>
<constraint>
<key value="cmp-2" />
<severity value="error" />
<human value="A section can only have an emptyReason if it is empty" />
<expression value="emptyReason.empty() or entry.empty()" />
<xpath value="not(exists(f:emptyReason) and exists(f:entry))" />
<source value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps" />
</constraint>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ips-comp-1" />
<severity value="error" />
<human value="Either section.entry or emptyReason are present" />
<expression value="(entry.reference.exists() or emptyReason.exists())" />
<xpath value="(/f:entry.reference and not /f:emptyReason) or (not(/f:emptyReason) and /f:entry.reference)" />
<source value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.structuredBody.component.section" />
</mapping>
</element>
<element id="Composition.section:sectionMedications.id">
<path value="Composition.section.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionMedications.extension">
<path value="Composition.section.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionMedications.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<comment value="This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element" />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionMedications.modifierExtension">
<path value="Composition.section.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.section:sectionMedications.title">
<path value="Composition.section.title" />
<short value="Medication Summary section" />
<definition value="The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.\n\nMedication Summary" />
<comment value="The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." />
<requirements value="Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized." />
<alias value="header" />
<alias value="label" />
<alias value="caption" />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.title" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./title" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".title" />
</mapping>
</element>
<element id="Composition.section:sectionMedications.code">
<path value="Composition.section.code" />
<short value="Classification of section (recommended)" />
<definition value="A code identifying the kind of content contained within the section. This must be consistent with the section title." />
<comment value="The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." />
<requirements value="Provides computable standardized labels to topics within the document." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="10160-0" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CompositionSectionType" />
</extension>
<strength value="example" />
<description value="Classification of a section of a composition/document." />
<valueSet value="http://hl7.org/fhir/ValueSet/doc-section-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
</element>
<element id="Composition.section:sectionMedications.author">
<path value="Composition.section.author" />
<short value="Who and/or what authored the section" />
<definition value="Identifies who is responsible for the information in this section, not necessarily who typed it in." />
<requirements value="Identifies who is responsible for the content." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.author" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".author.assignedAuthor" />
</mapping>
</element>
<element id="Composition.section:sectionMedications.focus">
<path value="Composition.section.focus" />
<short value="Who/what the section is about, when it is not about the subject of composition" />
<definition value="The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources)." />
<comment value="Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.focus" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="cda" />
<map value=".subject? (CDA did not differentiate between subject and focus)" />
</mapping>
</element>
<element id="Composition.section:sectionMedications.text">
<path value="Composition.section.text" />
<short value="Text summary of the section, for human interpretation" />
<definition value="A human-readable narrative that contains the attested content of the section, 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." />
<comment value="Document profiles may define what content should be represented in the narrative to ensure clinical safety." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".text" />
</mapping>
</element>
<element id="Composition.section:sectionMedications.mode">
<path value="Composition.section.mode" />
<short value="working | snapshot | changes" />
<definition value="How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted." />
<comment value="This element is labeled as a modifier because a change list must not be misunderstood as a complete list." />
<requirements value="Sections are used in various ways, and it must be known in what way it is safe to use the entries in them." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.mode" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionMode" />
</extension>
<strength value="required" />
<description value="The processing mode that applies to this section." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-mode|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionMedications.orderedBy">
<path value="Composition.section.orderedBy" />
<short value="Order of section entries" />
<definition value="Specifies the order applied to the items in the section entries." />
<comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order." />
<requirements value="Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.orderedBy" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEntryOrder" />
</extension>
<strength value="preferred" />
<description value="What order applies to the items in the entry." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-order" />
</binding>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP].sequenceNumber > 1" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionMedications.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Medications relevant for the scope of the patient summary" />
<definition value="This list the medications relevant for the scope of the patient summary or it is used to indicate that the subject is known not to be on any relevant medication" />
<comment value="This entry requires a medicationStatement or a medicationRequest." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionMedications.entry:medicationStatement">
<path value="Composition.section.entry" />
<sliceName value="medicationStatement" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/medicationstatement-ca-ps" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionMedications.entry:medicationRequest">
<path value="Composition.section.entry" />
<sliceName value="medicationRequest" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/medicationrequest-ca-ps" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionMedications.emptyReason">
<path value="Composition.section.emptyReason" />
<short value="Why the section is empty" />
<definition value="If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason." />
<comment value="The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases." />
<requirements value="Allows capturing things like "none exist" or "not asked" which can be important for most lists." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEmptyReason" />
</extension>
<strength value="preferred" />
<description value="If a section is empty, why it is empty." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-empty-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionMedications.section">
<path value="Composition.section.section" />
<short value="Nested Section" />
<definition value="A nested sub-section within this section." />
<comment value="Nested sections are primarily used to help human readers navigate to particular portions of the document." />
<min value="0" />
<max value="0" />
<base>
<path value="Composition.section.section" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" />
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.section" />
</mapping>
</element>
<element id="Composition.section:sectionAllergies">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionAllergies" />
<short value="PS-CA Allergies and Intolerances Section" />
<definition value="This section documents the relevant allergies or intolerances (conditions) for that patient, describing the kind of reaction (e.g., rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy.\nAt a minimum, it should list currently active and any relevant historical allergies and adverse reactions.\nIf no information about allergies is available, or if no allergies are known this should be clearly documented in the section." />
<comment value="IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of data - though has recently updated to allow for the provision of section.emptyReason. This constraint has been maintained in the PS-CA. Systems should utilize the section.entry with a resource when conveying that the subject has no known allergies (e.g., clinical assertions that are captured alongside supportive data like date). The section.emptyReason is available to convey details for why the section entry is empty (e.g., data unavailable)." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="cmp-1" />
<severity value="error" />
<human value="A section must contain at least one of text, entries, or sub-sections" />
<expression value="text.exists() or entry.exists() or section.exists()" />
<xpath value="exists(f:text) or exists(f:entry) or exists(f:section)" />
<source value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps" />
</constraint>
<constraint>
<key value="cmp-2" />
<severity value="error" />
<human value="A section can only have an emptyReason if it is empty" />
<expression value="emptyReason.empty() or entry.empty()" />
<xpath value="not(exists(f:emptyReason) and exists(f:entry))" />
<source value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps" />
</constraint>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ips-comp-1" />
<severity value="error" />
<human value="Either section.entry or emptyReason are present" />
<expression value="(entry.reference.exists() or emptyReason.exists())" />
<xpath value="(/f:entry.reference and not /f:emptyReason) or (not(/f:emptyReason) and /f:entry.reference)" />
<source value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.structuredBody.component.section" />
</mapping>
</element>
<element id="Composition.section:sectionAllergies.id">
<path value="Composition.section.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionAllergies.extension">
<path value="Composition.section.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionAllergies.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<comment value="This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element" />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionAllergies.modifierExtension">
<path value="Composition.section.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.section:sectionAllergies.title">
<path value="Composition.section.title" />
<short value="Allergies and Intolerances" />
<definition value="The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents." />
<comment value="The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." />
<requirements value="Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized." />
<alias value="header" />
<alias value="label" />
<alias value="caption" />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.title" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./title" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".title" />
</mapping>
</element>
<element id="Composition.section:sectionAllergies.code">
<path value="Composition.section.code" />
<short value="Classification of section (recommended)" />
<definition value="A code identifying the kind of content contained within the section. This must be consistent with the section title." />
<comment value="The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." />
<requirements value="Provides computable standardized labels to topics within the document." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="48765-2" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CompositionSectionType" />
</extension>
<strength value="example" />
<description value="Classification of a section of a composition/document." />
<valueSet value="http://hl7.org/fhir/ValueSet/doc-section-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
</element>
<element id="Composition.section:sectionAllergies.author">
<path value="Composition.section.author" />
<short value="Who and/or what authored the section" />
<definition value="Identifies who is responsible for the information in this section, not necessarily who typed it in." />
<requirements value="Identifies who is responsible for the content." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.author" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".author.assignedAuthor" />
</mapping>
</element>
<element id="Composition.section:sectionAllergies.focus">
<path value="Composition.section.focus" />
<short value="Who/what the section is about, when it is not about the subject of composition" />
<definition value="The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources)." />
<comment value="Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.focus" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="cda" />
<map value=".subject? (CDA did not differentiate between subject and focus)" />
</mapping>
</element>
<element id="Composition.section:sectionAllergies.text">
<path value="Composition.section.text" />
<short value="Text summary of the section, for human interpretation" />
<definition value="A human-readable narrative that contains the attested content of the section, 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." />
<comment value="Document profiles may define what content should be represented in the narrative to ensure clinical safety." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".text" />
</mapping>
</element>
<element id="Composition.section:sectionAllergies.mode">
<path value="Composition.section.mode" />
<short value="working | snapshot | changes" />
<definition value="How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted." />
<comment value="This element is labeled as a modifier because a change list must not be misunderstood as a complete list." />
<requirements value="Sections are used in various ways, and it must be known in what way it is safe to use the entries in them." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.mode" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionMode" />
</extension>
<strength value="required" />
<description value="The processing mode that applies to this section." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-mode|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionAllergies.orderedBy">
<path value="Composition.section.orderedBy" />
<short value="Order of section entries" />
<definition value="Specifies the order applied to the items in the section entries." />
<comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order." />
<requirements value="Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.orderedBy" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEntryOrder" />
</extension>
<strength value="preferred" />
<description value="What order applies to the items in the entry." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-order" />
</binding>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP].sequenceNumber > 1" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionAllergies.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Relevant allergies or intolerances (conditions) for that patient." />
<definition value="It lists the relevant allergies or intolerances (conditions) for that patient, describing the kind of reaction (e.g., rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy.\nAt a minimum, it should list currently active and any relevant historical allergies and adverse reactions." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionAllergies.entry:allergyOrIntolerance">
<path value="Composition.section.entry" />
<sliceName value="allergyOrIntolerance" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/allergyintolerance-ca-ps" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionAllergies.emptyReason">
<path value="Composition.section.emptyReason" />
<short value="Why the section is empty" />
<definition value="If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason." />
<comment value="The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases." />
<requirements value="Allows capturing things like "none exist" or "not asked" which can be important for most lists." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEmptyReason" />
</extension>
<strength value="preferred" />
<description value="If a section is empty, why it is empty." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-empty-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionAllergies.section">
<path value="Composition.section.section" />
<short value="Nested Section" />
<definition value="A nested sub-section within this section." />
<comment value="Nested sections are primarily used to help human readers navigate to particular portions of the document." />
<min value="0" />
<max value="0" />
<base>
<path value="Composition.section.section" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" />
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.section" />
</mapping>
</element>
<element id="Composition.section:sectionProblems">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionProblems" />
<short value="PS-CA Problems Section" />
<definition value="The PS problem section lists and describes clinical problems or conditions currently being monitored for the patient." />
<comment value="IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of data - though has recently updated to allow for the provision of section.emptyReason. This constraint has been maintained in the PS-CA. Systems should utilize the section.entry with a resource when conveying that the subject has no known conditions (e.g., clinical assertions that are captured alongside supportive data like date). The section.emptyReason is available to convey details for why the section entry is empty (e.g., data unavailable)." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="cmp-1" />
<severity value="error" />
<human value="A section must contain at least one of text, entries, or sub-sections" />
<expression value="text.exists() or entry.exists() or section.exists()" />
<xpath value="exists(f:text) or exists(f:entry) or exists(f:section)" />
<source value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps" />
</constraint>
<constraint>
<key value="cmp-2" />
<severity value="error" />
<human value="A section can only have an emptyReason if it is empty" />
<expression value="emptyReason.empty() or entry.empty()" />
<xpath value="not(exists(f:emptyReason) and exists(f:entry))" />
<source value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps" />
</constraint>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ips-comp-1" />
<severity value="error" />
<human value="Either section.entry or emptyReason are present" />
<expression value="(entry.reference.exists() or emptyReason.exists())" />
<xpath value="(/f:entry.reference and not /f:emptyReason) or (not(/f:emptyReason) and /f:entry.reference)" />
<source value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.structuredBody.component.section" />
</mapping>
</element>
<element id="Composition.section:sectionProblems.id">
<path value="Composition.section.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionProblems.extension">
<path value="Composition.section.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionProblems.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<comment value="This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element" />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionProblems.modifierExtension">
<path value="Composition.section.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.section:sectionProblems.title">
<path value="Composition.section.title" />
<short value="Label for section (e.g. for ToC)" />
<definition value="The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents." />
<comment value="The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." />
<requirements value="Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized." />
<alias value="header" />
<alias value="label" />
<alias value="caption" />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.title" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./title" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".title" />
</mapping>
</element>
<element id="Composition.section:sectionProblems.code">
<path value="Composition.section.code" />
<short value="Classification of section (recommended)" />
<definition value="A code identifying the kind of content contained within the section. This must be consistent with the section title." />
<comment value="The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." />
<requirements value="Provides computable standardized labels to topics within the document." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="11450-4" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CompositionSectionType" />
</extension>
<strength value="example" />
<description value="Classification of a section of a composition/document." />
<valueSet value="http://hl7.org/fhir/ValueSet/doc-section-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
</element>
<element id="Composition.section:sectionProblems.author">
<path value="Composition.section.author" />
<short value="Who and/or what authored the section" />
<definition value="Identifies who is responsible for the information in this section, not necessarily who typed it in." />
<requirements value="Identifies who is responsible for the content." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.author" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".author.assignedAuthor" />
</mapping>
</element>
<element id="Composition.section:sectionProblems.focus">
<path value="Composition.section.focus" />
<short value="Who/what the section is about, when it is not about the subject of composition" />
<definition value="The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources)." />
<comment value="Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.focus" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="cda" />
<map value=".subject? (CDA did not differentiate between subject and focus)" />
</mapping>
</element>
<element id="Composition.section:sectionProblems.text">
<path value="Composition.section.text" />
<short value="Text summary of the section, for human interpretation" />
<definition value="A human-readable narrative that contains the attested content of the section, 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." />
<comment value="Document profiles may define what content should be represented in the narrative to ensure clinical safety." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".text" />
</mapping>
</element>
<element id="Composition.section:sectionProblems.mode">
<path value="Composition.section.mode" />
<short value="working | snapshot | changes" />
<definition value="How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted." />
<comment value="This element is labeled as a modifier because a change list must not be misunderstood as a complete list." />
<requirements value="Sections are used in various ways, and it must be known in what way it is safe to use the entries in them." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.mode" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionMode" />
</extension>
<strength value="required" />
<description value="The processing mode that applies to this section." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-mode|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionProblems.orderedBy">
<path value="Composition.section.orderedBy" />
<short value="Order of section entries" />
<definition value="Specifies the order applied to the items in the section entries." />
<comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order." />
<requirements value="Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.orderedBy" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEntryOrder" />
</extension>
<strength value="preferred" />
<description value="What order applies to the items in the entry." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-order" />
</binding>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP].sequenceNumber > 1" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionProblems.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Clinical problems or conditions currently being monitored for the patient." />
<definition value="It lists and describes clinical problems or conditions currently being monitored for the patient." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionProblems.entry:problem">
<path value="Composition.section.entry" />
<sliceName value="problem" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/condition-ca-ps" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionProblems.emptyReason">
<path value="Composition.section.emptyReason" />
<short value="Why the section is empty" />
<definition value="If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason." />
<comment value="The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases." />
<requirements value="Allows capturing things like "none exist" or "not asked" which can be important for most lists." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEmptyReason" />
</extension>
<strength value="preferred" />
<description value="If a section is empty, why it is empty." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-empty-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionProblems.section">
<path value="Composition.section.section" />
<short value="Nested Section" />
<definition value="A nested sub-section within this section." />
<comment value="Nested sections are primarily used to help human readers navigate to particular portions of the document." />
<min value="0" />
<max value="0" />
<base>
<path value="Composition.section.section" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" />
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.section" />
</mapping>
</element>
<element id="Composition.section:sectionProceduresHx">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionProceduresHx" />
<short value="PS-CA History of Procedures Section" />
<definition value="The History of Procedures Section contains a description of the patient past procedures that are pertinent to the scope of this document.\nProcedures may refer for example to:\n1. Invasive Diagnostic procedure: e.g., Cardiac catheterization; (the results of these procedure are documented in the results section)\n2. Therapeutic procedure: e.g., dialysis;\n3. Surgical procedure: e.g., appendectomy" />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content" />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="cmp-1" />
<severity value="error" />
<human value="A section must contain at least one of text, entries, or sub-sections" />
<expression value="text.exists() or entry.exists() or section.exists()" />
<xpath value="exists(f:text) or exists(f:entry) or exists(f:section)" />
</constraint>
<constraint>
<key value="cmp-2" />
<severity value="error" />
<human value="A section can only have an emptyReason if it is empty" />
<expression value="emptyReason.empty() or entry.empty()" />
<xpath value="not(exists(f:emptyReason) and exists(f:entry))" />
</constraint>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.structuredBody.component.section" />
</mapping>
</element>
<element id="Composition.section:sectionProceduresHx.id">
<path value="Composition.section.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionProceduresHx.extension">
<path value="Composition.section.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionProceduresHx.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<comment value="This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element" />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionProceduresHx.modifierExtension">
<path value="Composition.section.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.section:sectionProceduresHx.title">
<path value="Composition.section.title" />
<short value="Label for section (e.g. for ToC)" />
<definition value="The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents." />
<comment value="The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." />
<requirements value="Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized." />
<alias value="header" />
<alias value="label" />
<alias value="caption" />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.title" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./title" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".title" />
</mapping>
</element>
<element id="Composition.section:sectionProceduresHx.code">
<path value="Composition.section.code" />
<short value="Classification of section (recommended)" />
<definition value="A code identifying the kind of content contained within the section. This must be consistent with the section title." />
<comment value="The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." />
<requirements value="Provides computable standardized labels to topics within the document." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="47519-4" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CompositionSectionType" />
</extension>
<strength value="example" />
<description value="Classification of a section of a composition/document." />
<valueSet value="http://hl7.org/fhir/ValueSet/doc-section-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
</element>
<element id="Composition.section:sectionProceduresHx.author">
<path value="Composition.section.author" />
<short value="Who and/or what authored the section" />
<definition value="Identifies who is responsible for the information in this section, not necessarily who typed it in." />
<requirements value="Identifies who is responsible for the content." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.author" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".author.assignedAuthor" />
</mapping>
</element>
<element id="Composition.section:sectionProceduresHx.focus">
<path value="Composition.section.focus" />
<short value="Who/what the section is about, when it is not about the subject of composition" />
<definition value="The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources)." />
<comment value="Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.focus" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="cda" />
<map value=".subject? (CDA did not differentiate between subject and focus)" />
</mapping>
</element>
<element id="Composition.section:sectionProceduresHx.text">
<path value="Composition.section.text" />
<short value="Text summary of the section, for human interpretation" />
<definition value="A human-readable narrative that contains the attested content of the section, 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." />
<comment value="Document profiles may define what content should be represented in the narrative to ensure clinical safety." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".text" />
</mapping>
</element>
<element id="Composition.section:sectionProceduresHx.mode">
<path value="Composition.section.mode" />
<short value="working | snapshot | changes" />
<definition value="How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted." />
<comment value="This element is labeled as a modifier because a change list must not be misunderstood as a complete list." />
<requirements value="Sections are used in various ways, and it must be known in what way it is safe to use the entries in them." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.mode" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionMode" />
</extension>
<strength value="required" />
<description value="The processing mode that applies to this section." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-mode|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionProceduresHx.orderedBy">
<path value="Composition.section.orderedBy" />
<short value="Order of section entries" />
<definition value="Specifies the order applied to the items in the section entries." />
<comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order." />
<requirements value="Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.orderedBy" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEntryOrder" />
</extension>
<strength value="preferred" />
<description value="What order applies to the items in the entry." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-order" />
</binding>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP].sequenceNumber > 1" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionProceduresHx.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Patient past procedures pertinent to the scope of this document." />
<definition value="It lists the patient past procedures that are pertinent to the scope of this document.\nProcedures may refer for example to:\n1. Invasive Diagnostic procedure: e.g., Cardiac catheterization; (the results of these procedure are documented in the results section)\n2. Therapeutic procedure: e.g., dialysis;\n3. Surgical procedure: e.g., appendectomy." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionProceduresHx.entry:procedure">
<path value="Composition.section.entry" />
<sliceName value="procedure" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/procedure-ca-ps" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionProceduresHx.emptyReason">
<path value="Composition.section.emptyReason" />
<short value="Why the section is empty" />
<definition value="If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason." />
<comment value="The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases." />
<requirements value="Allows capturing things like "none exist" or "not asked" which can be important for most lists." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEmptyReason" />
</extension>
<strength value="preferred" />
<description value="If a section is empty, why it is empty." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-empty-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionProceduresHx.section">
<path value="Composition.section.section" />
<short value="Nested Section" />
<definition value="A nested sub-section within this section." />
<comment value="Nested sections are primarily used to help human readers navigate to particular portions of the document." />
<min value="0" />
<max value="0" />
<base>
<path value="Composition.section.section" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" />
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.section" />
</mapping>
</element>
<element id="Composition.section:sectionImmunizations">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionImmunizations" />
<short value="PS-CA Immunizations Section" />
<definition value="The Immunizations Section defines a patient's current immunization status and pertinent immunization history.\nThe primary use case for the Immunization Section is to enable communication of a patient's immunization status.\nThe section includes the current immunization status, and may contain the entire immunization history that is relevant to the period of time being summarized." />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content" />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="cmp-1" />
<severity value="error" />
<human value="A section must contain at least one of text, entries, or sub-sections" />
<expression value="text.exists() or entry.exists() or section.exists()" />
<xpath value="exists(f:text) or exists(f:entry) or exists(f:section)" />
</constraint>
<constraint>
<key value="cmp-2" />
<severity value="error" />
<human value="A section can only have an emptyReason if it is empty" />
<expression value="emptyReason.empty() or entry.empty()" />
<xpath value="not(exists(f:emptyReason) and exists(f:entry))" />
</constraint>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.structuredBody.component.section" />
</mapping>
</element>
<element id="Composition.section:sectionImmunizations.id">
<path value="Composition.section.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionImmunizations.extension">
<path value="Composition.section.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionImmunizations.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<comment value="This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element" />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionImmunizations.modifierExtension">
<path value="Composition.section.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.section:sectionImmunizations.title">
<path value="Composition.section.title" />
<short value="Label for section (e.g. for ToC)" />
<definition value="The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents." />
<comment value="The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." />
<requirements value="Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized." />
<alias value="header" />
<alias value="label" />
<alias value="caption" />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.title" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./title" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".title" />
</mapping>
</element>
<element id="Composition.section:sectionImmunizations.code">
<path value="Composition.section.code" />
<short value="Classification of section (recommended)" />
<definition value="A code identifying the kind of content contained within the section. This must be consistent with the section title." />
<comment value="The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." />
<requirements value="Provides computable standardized labels to topics within the document." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="11369-6" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CompositionSectionType" />
</extension>
<strength value="example" />
<description value="Classification of a section of a composition/document." />
<valueSet value="http://hl7.org/fhir/ValueSet/doc-section-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
</element>
<element id="Composition.section:sectionImmunizations.author">
<path value="Composition.section.author" />
<short value="Who and/or what authored the section" />
<definition value="Identifies who is responsible for the information in this section, not necessarily who typed it in." />
<requirements value="Identifies who is responsible for the content." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.author" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".author.assignedAuthor" />
</mapping>
</element>
<element id="Composition.section:sectionImmunizations.focus">
<path value="Composition.section.focus" />
<short value="Who/what the section is about, when it is not about the subject of composition" />
<definition value="The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources)." />
<comment value="Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.focus" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="cda" />
<map value=".subject? (CDA did not differentiate between subject and focus)" />
</mapping>
</element>
<element id="Composition.section:sectionImmunizations.text">
<path value="Composition.section.text" />
<short value="Text summary of the section, for human interpretation" />
<definition value="A human-readable narrative that contains the attested content of the section, 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." />
<comment value="Document profiles may define what content should be represented in the narrative to ensure clinical safety." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".text" />
</mapping>
</element>
<element id="Composition.section:sectionImmunizations.mode">
<path value="Composition.section.mode" />
<short value="working | snapshot | changes" />
<definition value="How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted." />
<comment value="This element is labeled as a modifier because a change list must not be misunderstood as a complete list." />
<requirements value="Sections are used in various ways, and it must be known in what way it is safe to use the entries in them." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.mode" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionMode" />
</extension>
<strength value="required" />
<description value="The processing mode that applies to this section." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-mode|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionImmunizations.orderedBy">
<path value="Composition.section.orderedBy" />
<short value="Order of section entries" />
<definition value="Specifies the order applied to the items in the section entries." />
<comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order." />
<requirements value="Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.orderedBy" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEntryOrder" />
</extension>
<strength value="preferred" />
<description value="What order applies to the items in the entry." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-order" />
</binding>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP].sequenceNumber > 1" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionImmunizations.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Patient's immunization status and pertinent history." />
<definition value="It defines the patient's current immunization status and pertinent immunization history.\nThe primary use case for the Immunization Section is to enable communication of a patient's immunization status.\nIt may contain the entire immunization history that is relevant to the period of time being summarized." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionImmunizations.entry:immunization">
<path value="Composition.section.entry" />
<sliceName value="immunization" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/immunization-ca-ps" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionImmunizations.emptyReason">
<path value="Composition.section.emptyReason" />
<short value="Why the section is empty" />
<definition value="If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason." />
<comment value="The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases." />
<requirements value="Allows capturing things like "none exist" or "not asked" which can be important for most lists." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEmptyReason" />
</extension>
<strength value="preferred" />
<description value="If a section is empty, why it is empty." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-empty-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionImmunizations.section">
<path value="Composition.section.section" />
<short value="Nested Section" />
<definition value="A nested sub-section within this section." />
<comment value="Nested sections are primarily used to help human readers navigate to particular portions of the document." />
<min value="0" />
<max value="0" />
<base>
<path value="Composition.section.section" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" />
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.section" />
</mapping>
</element>
<element id="Composition.section:sectionMedicalDevices">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionMedicalDevices" />
<short value="PS-CA Medical Devices Section" />
<definition value="The medical devices section contains narrative text and coded entries describing the patient history of medical device use." />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries, future releases may further constrain this section as more jurisdictions look to support its use" />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="cmp-1" />
<severity value="error" />
<human value="A section must contain at least one of text, entries, or sub-sections" />
<expression value="text.exists() or entry.exists() or section.exists()" />
<xpath value="exists(f:text) or exists(f:entry) or exists(f:section)" />
</constraint>
<constraint>
<key value="cmp-2" />
<severity value="error" />
<human value="A section can only have an emptyReason if it is empty" />
<expression value="emptyReason.empty() or entry.empty()" />
<xpath value="not(exists(f:emptyReason) and exists(f:entry))" />
</constraint>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.structuredBody.component.section" />
</mapping>
</element>
<element id="Composition.section:sectionMedicalDevices.id">
<path value="Composition.section.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionMedicalDevices.extension">
<path value="Composition.section.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionMedicalDevices.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<comment value="This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element" />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionMedicalDevices.modifierExtension">
<path value="Composition.section.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.section:sectionMedicalDevices.title">
<path value="Composition.section.title" />
<short value="Label for section (e.g. for ToC)" />
<definition value="The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents." />
<comment value="The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." />
<requirements value="Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized." />
<alias value="header" />
<alias value="label" />
<alias value="caption" />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.title" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./title" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".title" />
</mapping>
</element>
<element id="Composition.section:sectionMedicalDevices.code">
<path value="Composition.section.code" />
<short value="Classification of section (recommended)" />
<definition value="A code identifying the kind of content contained within the section. This must be consistent with the section title." />
<comment value="The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." />
<requirements value="Provides computable standardized labels to topics within the document." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="46264-8" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CompositionSectionType" />
</extension>
<strength value="example" />
<description value="Classification of a section of a composition/document." />
<valueSet value="http://hl7.org/fhir/ValueSet/doc-section-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
</element>
<element id="Composition.section:sectionMedicalDevices.author">
<path value="Composition.section.author" />
<short value="Who and/or what authored the section" />
<definition value="Identifies who is responsible for the information in this section, not necessarily who typed it in." />
<requirements value="Identifies who is responsible for the content." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.author" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".author.assignedAuthor" />
</mapping>
</element>
<element id="Composition.section:sectionMedicalDevices.focus">
<path value="Composition.section.focus" />
<short value="Who/what the section is about, when it is not about the subject of composition" />
<definition value="The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources)." />
<comment value="Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.focus" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="cda" />
<map value=".subject? (CDA did not differentiate between subject and focus)" />
</mapping>
</element>
<element id="Composition.section:sectionMedicalDevices.text">
<path value="Composition.section.text" />
<short value="Text summary of the section, for human interpretation" />
<definition value="A human-readable narrative that contains the attested content of the section, 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." />
<comment value="Document profiles may define what content should be represented in the narrative to ensure clinical safety." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".text" />
</mapping>
</element>
<element id="Composition.section:sectionMedicalDevices.mode">
<path value="Composition.section.mode" />
<short value="working | snapshot | changes" />
<definition value="How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted." />
<comment value="This element is labeled as a modifier because a change list must not be misunderstood as a complete list." />
<requirements value="Sections are used in various ways, and it must be known in what way it is safe to use the entries in them." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.mode" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionMode" />
</extension>
<strength value="required" />
<description value="The processing mode that applies to this section." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-mode|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionMedicalDevices.orderedBy">
<path value="Composition.section.orderedBy" />
<short value="Order of section entries" />
<definition value="Specifies the order applied to the items in the section entries." />
<comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order." />
<requirements value="Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.orderedBy" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEntryOrder" />
</extension>
<strength value="preferred" />
<description value="What order applies to the items in the entry." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-order" />
</binding>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP].sequenceNumber > 1" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionMedicalDevices.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Patient history of medical device use." />
<definition value="It describes the patient history of medical device use. This entry shall be used to document that no information about medical device use is available, or that no relevant medical device use is known." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionMedicalDevices.entry:deviceStatement">
<path value="Composition.section.entry" />
<sliceName value="deviceStatement" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="Pending definition of a PS CA device use section profile in a future release of PS CA, implementors are encouraged to use the IPS device use section profile." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/uv/ips/StructureDefinition/DeviceUseStatement-uv-ips" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionMedicalDevices.emptyReason">
<path value="Composition.section.emptyReason" />
<short value="Why the section is empty" />
<definition value="If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason." />
<comment value="The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases." />
<requirements value="Allows capturing things like "none exist" or "not asked" which can be important for most lists." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEmptyReason" />
</extension>
<strength value="preferred" />
<description value="If a section is empty, why it is empty." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-empty-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionMedicalDevices.section">
<path value="Composition.section.section" />
<short value="Nested Section" />
<definition value="A nested sub-section within this section." />
<comment value="Nested sections are primarily used to help human readers navigate to particular portions of the document." />
<min value="0" />
<max value="0" />
<base>
<path value="Composition.section.section" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" />
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.section" />
</mapping>
</element>
<element id="Composition.section:sectionResults">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Results Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionResults" />
<short value="PS-CA Results Section" />
<definition value="This section assembles relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. Some of these results may be laboratory results, others may be anatomic pathology results, others, radiology results, and others, clinical results." />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content" />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="cmp-1" />
<severity value="error" />
<human value="A section must contain at least one of text, entries, or sub-sections" />
<expression value="text.exists() or entry.exists() or section.exists()" />
<xpath value="exists(f:text) or exists(f:entry) or exists(f:section)" />
</constraint>
<constraint>
<key value="cmp-2" />
<severity value="error" />
<human value="A section can only have an emptyReason if it is empty" />
<expression value="emptyReason.empty() or entry.empty()" />
<xpath value="not(exists(f:emptyReason) and exists(f:entry))" />
</constraint>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.structuredBody.component.section" />
</mapping>
</element>
<element id="Composition.section:sectionResults.id">
<path value="Composition.section.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionResults.extension">
<path value="Composition.section.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionResults.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<comment value="This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element" />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionResults.modifierExtension">
<path value="Composition.section.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.section:sectionResults.title">
<path value="Composition.section.title" />
<short value="Label for section (e.g. for ToC)" />
<definition value="The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents." />
<comment value="The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." />
<requirements value="Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized." />
<alias value="header" />
<alias value="label" />
<alias value="caption" />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.title" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./title" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".title" />
</mapping>
</element>
<element id="Composition.section:sectionResults.code">
<path value="Composition.section.code" />
<short value="Classification of section (recommended)" />
<definition value="A code identifying the kind of content contained within the section. This must be consistent with the section title." />
<comment value="The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." />
<requirements value="Provides computable standardized labels to topics within the document." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="30954-2" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CompositionSectionType" />
</extension>
<strength value="example" />
<description value="Classification of a section of a composition/document." />
<valueSet value="http://hl7.org/fhir/ValueSet/doc-section-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
</element>
<element id="Composition.section:sectionResults.author">
<path value="Composition.section.author" />
<short value="Who and/or what authored the section" />
<definition value="Identifies who is responsible for the information in this section, not necessarily who typed it in." />
<requirements value="Identifies who is responsible for the content." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.author" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".author.assignedAuthor" />
</mapping>
</element>
<element id="Composition.section:sectionResults.focus">
<path value="Composition.section.focus" />
<short value="Who/what the section is about, when it is not about the subject of composition" />
<definition value="The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources)." />
<comment value="Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.focus" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="cda" />
<map value=".subject? (CDA did not differentiate between subject and focus)" />
</mapping>
</element>
<element id="Composition.section:sectionResults.text">
<path value="Composition.section.text" />
<short value="Text summary of the section, for human interpretation" />
<definition value="A human-readable narrative that contains the attested content of the section, 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." />
<comment value="Document profiles may define what content should be represented in the narrative to ensure clinical safety." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".text" />
</mapping>
</element>
<element id="Composition.section:sectionResults.mode">
<path value="Composition.section.mode" />
<short value="working | snapshot | changes" />
<definition value="How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted." />
<comment value="This element is labeled as a modifier because a change list must not be misunderstood as a complete list." />
<requirements value="Sections are used in various ways, and it must be known in what way it is safe to use the entries in them." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.mode" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionMode" />
</extension>
<strength value="required" />
<description value="The processing mode that applies to this section." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-mode|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionResults.orderedBy">
<path value="Composition.section.orderedBy" />
<short value="Order of section entries" />
<definition value="Specifies the order applied to the items in the section entries." />
<comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order." />
<requirements value="Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.orderedBy" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEntryOrder" />
</extension>
<strength value="preferred" />
<description value="What order applies to the items in the entry." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-order" />
</binding>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP].sequenceNumber > 1" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionResults.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient." />
<definition value="Relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. Some of these results may be laboratory results, others may be anatomic pathology results, others, radiology results, and others, clinical results." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionResults.entry:results-observation-laboratory-pathology">
<path value="Composition.section.entry" />
<sliceName value="results-observation-laboratory-pathology" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-results-laboratory-pathology-ca-ps" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionResults.entry:results-observation-radiology">
<path value="Composition.section.entry" />
<sliceName value="results-observation-radiology" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-results-radiology-ca-ps" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionResults.entry:results-diagnosticReport">
<path value="Composition.section.entry" />
<sliceName value="results-diagnosticReport" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="Pending definition of a PS CA diagnostic report profile in a future release of PS CA, implementors are encouraged to use the IPS diagnostic report profile." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/diagnosticreport-ca-ps" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionResults.emptyReason">
<path value="Composition.section.emptyReason" />
<short value="Why the section is empty" />
<definition value="If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason." />
<comment value="The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases." />
<requirements value="Allows capturing things like "none exist" or "not asked" which can be important for most lists." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEmptyReason" />
</extension>
<strength value="preferred" />
<description value="If a section is empty, why it is empty." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-empty-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionResults.section">
<path value="Composition.section.section" />
<short value="Nested Section" />
<definition value="A nested sub-section within this section." />
<comment value="Nested sections are primarily used to help human readers navigate to particular portions of the document." />
<min value="0" />
<max value="0" />
<base>
<path value="Composition.section.section" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" />
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.section" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Vital Signs Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionVitalSigns" />
<label value="Vital signs" />
<short value="PS-CA Vital Signs Section" />
<definition value="The Vital signs section includes blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included" />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content" />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="cmp-1" />
<severity value="error" />
<human value="A section must contain at least one of text, entries, or sub-sections" />
<expression value="text.exists() or entry.exists() or section.exists()" />
<xpath value="exists(f:text) or exists(f:entry) or exists(f:section)" />
</constraint>
<constraint>
<key value="cmp-2" />
<severity value="error" />
<human value="A section can only have an emptyReason if it is empty" />
<expression value="emptyReason.empty() or entry.empty()" />
<xpath value="not(exists(f:emptyReason) and exists(f:entry))" />
</constraint>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.structuredBody.component.section" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.id">
<path value="Composition.section.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.extension">
<path value="Composition.section.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<comment value="This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element" />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.modifierExtension">
<path value="Composition.section.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.title">
<path value="Composition.section.title" />
<short value="Label for section (e.g. for ToC)" />
<definition value="The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents." />
<comment value="The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." />
<requirements value="Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized." />
<alias value="header" />
<alias value="label" />
<alias value="caption" />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.title" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./title" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".title" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.code">
<path value="Composition.section.code" />
<short value="Classification of section (recommended)" />
<definition value="A code identifying the kind of content contained within the section. This must be consistent with the section title." />
<comment value="The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." />
<requirements value="Provides computable standardized labels to topics within the document." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="8716-3" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CompositionSectionType" />
</extension>
<strength value="example" />
<description value="Classification of a section of a composition/document." />
<valueSet value="http://hl7.org/fhir/ValueSet/doc-section-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.author">
<path value="Composition.section.author" />
<short value="Who and/or what authored the section" />
<definition value="Identifies who is responsible for the information in this section, not necessarily who typed it in." />
<requirements value="Identifies who is responsible for the content." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.author" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".author.assignedAuthor" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.focus">
<path value="Composition.section.focus" />
<short value="Who/what the section is about, when it is not about the subject of composition" />
<definition value="The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources)." />
<comment value="Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.focus" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="cda" />
<map value=".subject? (CDA did not differentiate between subject and focus)" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.text">
<path value="Composition.section.text" />
<short value="Text summary of the section, for human interpretation" />
<definition value="A human-readable narrative that contains the attested content of the section, 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." />
<comment value="Document profiles may define what content should be represented in the narrative to ensure clinical safety." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".text" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.mode">
<path value="Composition.section.mode" />
<short value="working | snapshot | changes" />
<definition value="How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted." />
<comment value="This element is labeled as a modifier because a change list must not be misunderstood as a complete list." />
<requirements value="Sections are used in various ways, and it must be known in what way it is safe to use the entries in them." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.mode" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionMode" />
</extension>
<strength value="required" />
<description value="The processing mode that applies to this section." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-mode|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.orderedBy">
<path value="Composition.section.orderedBy" />
<short value="Order of section entries" />
<definition value="Specifies the order applied to the items in the section entries." />
<comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order." />
<requirements value="Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.orderedBy" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEntryOrder" />
</extension>
<strength value="preferred" />
<description value="What order applies to the items in the entry." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-order" />
</binding>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP].sequenceNumber > 1" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Notable vital signs or physical findings." />
<definition value="Notable vital signs or physical findings as: blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included" />
<comment value="IPS-UV and PS-CA point to the parent vital signs profile (http://hl7.org/fhir/StructureDefinition/vitalsigns) in the base FHIR specification, it is up to the jurisdictions to select and support the individual vital sign profiles. However, to support implementers in validation - the individual vital signs profiles have been included as individual slices below. The parent vital signs profile has been removed as a slice to prevent examples from matching multiple slices." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.entry:BMI">
<path value="Composition.section.entry" />
<sliceName value="BMI" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/bmi" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.entry:BP">
<path value="Composition.section.entry" />
<sliceName value="BP" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/bp" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.entry:BodyHeight">
<path value="Composition.section.entry" />
<sliceName value="BodyHeight" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/bodyheight" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.entry:BodyTemp">
<path value="Composition.section.entry" />
<sliceName value="BodyTemp" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/bodytemp" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.entry:BodyWeight">
<path value="Composition.section.entry" />
<sliceName value="BodyWeight" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/bodyweight" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.entry:HeadCircum">
<path value="Composition.section.entry" />
<sliceName value="HeadCircum" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/headcircum" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.entry:HeartRate">
<path value="Composition.section.entry" />
<sliceName value="HeartRate" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/heartrate" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.entry:OxygenSat">
<path value="Composition.section.entry" />
<sliceName value="OxygenSat" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/oxygensat" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.entry:RespRate">
<path value="Composition.section.entry" />
<sliceName value="RespRate" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/resprate" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.entry:VitalsPanel">
<path value="Composition.section.entry" />
<sliceName value="VitalsPanel" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/vitalspanel" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.emptyReason">
<path value="Composition.section.emptyReason" />
<short value="Why the section is empty" />
<definition value="If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason." />
<comment value="The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases." />
<requirements value="Allows capturing things like "none exist" or "not asked" which can be important for most lists." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEmptyReason" />
</extension>
<strength value="preferred" />
<description value="If a section is empty, why it is empty." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-empty-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionVitalSigns.section">
<path value="Composition.section.section" />
<short value="Nested Section" />
<definition value="A nested sub-section within this section." />
<comment value="Nested sections are primarily used to help human readers navigate to particular portions of the document." />
<min value="0" />
<max value="0" />
<base>
<path value="Composition.section.section" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" />
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.section" />
</mapping>
</element>
<element id="Composition.section:sectionPastIllnessHx">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionPastIllnessHx" />
<short value="PS-CA History of Past Illness Section" />
<definition value="The History of Past Illness section contains a description of the conditions the patient suffered in the past." />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content" />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="cmp-1" />
<severity value="error" />
<human value="A section must contain at least one of text, entries, or sub-sections" />
<expression value="text.exists() or entry.exists() or section.exists()" />
<xpath value="exists(f:text) or exists(f:entry) or exists(f:section)" />
</constraint>
<constraint>
<key value="cmp-2" />
<severity value="error" />
<human value="A section can only have an emptyReason if it is empty" />
<expression value="emptyReason.empty() or entry.empty()" />
<xpath value="not(exists(f:emptyReason) and exists(f:entry))" />
</constraint>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.structuredBody.component.section" />
</mapping>
</element>
<element id="Composition.section:sectionPastIllnessHx.id">
<path value="Composition.section.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPastIllnessHx.extension">
<path value="Composition.section.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPastIllnessHx.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<comment value="This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element" />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPastIllnessHx.modifierExtension">
<path value="Composition.section.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.section:sectionPastIllnessHx.title">
<path value="Composition.section.title" />
<short value="Label for section (e.g. for ToC)" />
<definition value="The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents." />
<comment value="The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." />
<requirements value="Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized." />
<alias value="header" />
<alias value="label" />
<alias value="caption" />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.title" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./title" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".title" />
</mapping>
</element>
<element id="Composition.section:sectionPastIllnessHx.code">
<path value="Composition.section.code" />
<short value="Classification of section (recommended)" />
<definition value="A code identifying the kind of content contained within the section. This must be consistent with the section title." />
<comment value="The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." />
<requirements value="Provides computable standardized labels to topics within the document." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="11348-0" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CompositionSectionType" />
</extension>
<strength value="example" />
<description value="Classification of a section of a composition/document." />
<valueSet value="http://hl7.org/fhir/ValueSet/doc-section-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
</element>
<element id="Composition.section:sectionPastIllnessHx.author">
<path value="Composition.section.author" />
<short value="Who and/or what authored the section" />
<definition value="Identifies who is responsible for the information in this section, not necessarily who typed it in." />
<requirements value="Identifies who is responsible for the content." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.author" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".author.assignedAuthor" />
</mapping>
</element>
<element id="Composition.section:sectionPastIllnessHx.focus">
<path value="Composition.section.focus" />
<short value="Who/what the section is about, when it is not about the subject of composition" />
<definition value="The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources)." />
<comment value="Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.focus" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="cda" />
<map value=".subject? (CDA did not differentiate between subject and focus)" />
</mapping>
</element>
<element id="Composition.section:sectionPastIllnessHx.text">
<path value="Composition.section.text" />
<short value="Text summary of the section, for human interpretation" />
<definition value="A human-readable narrative that contains the attested content of the section, 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." />
<comment value="Document profiles may define what content should be represented in the narrative to ensure clinical safety." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".text" />
</mapping>
</element>
<element id="Composition.section:sectionPastIllnessHx.mode">
<path value="Composition.section.mode" />
<short value="working | snapshot | changes" />
<definition value="How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted." />
<comment value="This element is labeled as a modifier because a change list must not be misunderstood as a complete list." />
<requirements value="Sections are used in various ways, and it must be known in what way it is safe to use the entries in them." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.mode" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionMode" />
</extension>
<strength value="required" />
<description value="The processing mode that applies to this section." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-mode|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPastIllnessHx.orderedBy">
<path value="Composition.section.orderedBy" />
<short value="Order of section entries" />
<definition value="Specifies the order applied to the items in the section entries." />
<comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order." />
<requirements value="Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.orderedBy" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEntryOrder" />
</extension>
<strength value="preferred" />
<description value="What order applies to the items in the entry." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-order" />
</binding>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP].sequenceNumber > 1" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPastIllnessHx.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Conditions the patient suffered in the past." />
<definition value="It contains a description of the conditions the patient suffered in the past." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionPastIllnessHx.entry:pastProblem">
<path value="Composition.section.entry" />
<sliceName value="pastProblem" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/condition-ca-ps" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionPastIllnessHx.emptyReason">
<path value="Composition.section.emptyReason" />
<short value="Why the section is empty" />
<definition value="If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason." />
<comment value="The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases." />
<requirements value="Allows capturing things like "none exist" or "not asked" which can be important for most lists." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEmptyReason" />
</extension>
<strength value="preferred" />
<description value="If a section is empty, why it is empty." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-empty-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPastIllnessHx.section">
<path value="Composition.section.section" />
<short value="Nested Section" />
<definition value="A nested sub-section within this section." />
<comment value="Nested sections are primarily used to help human readers navigate to particular portions of the document." />
<min value="0" />
<max value="0" />
<base>
<path value="Composition.section.section" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" />
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.section" />
</mapping>
</element>
<element id="Composition.section:sectionFunctionalStatus">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionFunctionalStatus" />
<short value="PS-CA Functional Status" />
<definition value="The functional status section shall contain a narrative description of capability of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments.\nProfiles to express disabilities and functional assessments will be specified by future versions of this guide." />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="cmp-1" />
<severity value="error" />
<human value="A section must contain at least one of text, entries, or sub-sections" />
<expression value="text.exists() or entry.exists() or section.exists()" />
<xpath value="exists(f:text) or exists(f:entry) or exists(f:section)" />
</constraint>
<constraint>
<key value="cmp-2" />
<severity value="error" />
<human value="A section can only have an emptyReason if it is empty" />
<expression value="emptyReason.empty() or entry.empty()" />
<xpath value="not(exists(f:emptyReason) and exists(f:entry))" />
</constraint>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.structuredBody.component.section" />
</mapping>
</element>
<element id="Composition.section:sectionFunctionalStatus.id">
<path value="Composition.section.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionFunctionalStatus.extension">
<path value="Composition.section.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionFunctionalStatus.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<comment value="This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element" />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionFunctionalStatus.modifierExtension">
<path value="Composition.section.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.section:sectionFunctionalStatus.title">
<path value="Composition.section.title" />
<short value="Label for section (e.g. for ToC)" />
<definition value="The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents." />
<comment value="The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." />
<requirements value="Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized." />
<alias value="header" />
<alias value="label" />
<alias value="caption" />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.title" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./title" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".title" />
</mapping>
</element>
<element id="Composition.section:sectionFunctionalStatus.code">
<path value="Composition.section.code" />
<short value="Classification of section (recommended)" />
<definition value="A code identifying the kind of content contained within the section. This must be consistent with the section title." />
<comment value="The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." />
<requirements value="Provides computable standardized labels to topics within the document." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="47420-5" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CompositionSectionType" />
</extension>
<strength value="example" />
<description value="Classification of a section of a composition/document." />
<valueSet value="http://hl7.org/fhir/ValueSet/doc-section-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
</element>
<element id="Composition.section:sectionFunctionalStatus.author">
<path value="Composition.section.author" />
<short value="Who and/or what authored the section" />
<definition value="Identifies who is responsible for the information in this section, not necessarily who typed it in." />
<requirements value="Identifies who is responsible for the content." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.author" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".author.assignedAuthor" />
</mapping>
</element>
<element id="Composition.section:sectionFunctionalStatus.focus">
<path value="Composition.section.focus" />
<short value="Who/what the section is about, when it is not about the subject of composition" />
<definition value="The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources)." />
<comment value="Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.focus" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="cda" />
<map value=".subject? (CDA did not differentiate between subject and focus)" />
</mapping>
</element>
<element id="Composition.section:sectionFunctionalStatus.text">
<path value="Composition.section.text" />
<short value="Text summary of the section, for human interpretation" />
<definition value="A human-readable narrative that contains the attested content of the section, 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." />
<comment value="Document profiles may define what content should be represented in the narrative to ensure clinical safety." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".text" />
</mapping>
</element>
<element id="Composition.section:sectionFunctionalStatus.mode">
<path value="Composition.section.mode" />
<short value="working | snapshot | changes" />
<definition value="How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted." />
<comment value="This element is labeled as a modifier because a change list must not be misunderstood as a complete list." />
<requirements value="Sections are used in various ways, and it must be known in what way it is safe to use the entries in them." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.mode" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionMode" />
</extension>
<strength value="required" />
<description value="The processing mode that applies to this section." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-mode|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionFunctionalStatus.orderedBy">
<path value="Composition.section.orderedBy" />
<short value="Order of section entries" />
<definition value="Specifies the order applied to the items in the section entries." />
<comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order." />
<requirements value="Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.orderedBy" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEntryOrder" />
</extension>
<strength value="preferred" />
<description value="What order applies to the items in the entry." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-order" />
</binding>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP].sequenceNumber > 1" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionFunctionalStatus.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Optional entry used to represent disabilities and functional assessments" />
<definition value="It describes capabilities of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments.\nProfiles to express disabilities and functional assessments will be specified by future versions of this guide." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionFunctionalStatus.entry:disability">
<path value="Composition.section.entry" />
<sliceName value="disability" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/condition-ca-ps" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionFunctionalStatus.entry:functionalAssessment">
<path value="Composition.section.entry" />
<sliceName value="functionalAssessment" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ClinicalImpression" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionFunctionalStatus.emptyReason">
<path value="Composition.section.emptyReason" />
<short value="Why the section is empty" />
<definition value="If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason." />
<comment value="The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases." />
<requirements value="Allows capturing things like "none exist" or "not asked" which can be important for most lists." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEmptyReason" />
</extension>
<strength value="preferred" />
<description value="If a section is empty, why it is empty." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-empty-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionFunctionalStatus.section">
<path value="Composition.section.section" />
<short value="Nested Section" />
<definition value="A nested sub-section within this section." />
<comment value="Nested sections are primarily used to help human readers navigate to particular portions of the document." />
<min value="0" />
<max value="0" />
<base>
<path value="Composition.section.section" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" />
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.section" />
</mapping>
</element>
<element id="Composition.section:sectionPlanOfCare">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionPlanOfCare" />
<short value="PS-CA Plan of Care Section" />
<definition value="The plan of care section contains a narrative description of the expectations for care including proposals, goals, and order requests for monitoring, tracking, or improving the condition of the patient." />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="cmp-1" />
<severity value="error" />
<human value="A section must contain at least one of text, entries, or sub-sections" />
<expression value="text.exists() or entry.exists() or section.exists()" />
<xpath value="exists(f:text) or exists(f:entry) or exists(f:section)" />
</constraint>
<constraint>
<key value="cmp-2" />
<severity value="error" />
<human value="A section can only have an emptyReason if it is empty" />
<expression value="emptyReason.empty() or entry.empty()" />
<xpath value="not(exists(f:emptyReason) and exists(f:entry))" />
</constraint>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.structuredBody.component.section" />
</mapping>
</element>
<element id="Composition.section:sectionPlanOfCare.id">
<path value="Composition.section.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPlanOfCare.extension">
<path value="Composition.section.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPlanOfCare.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<comment value="This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element" />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPlanOfCare.modifierExtension">
<path value="Composition.section.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.section:sectionPlanOfCare.title">
<path value="Composition.section.title" />
<short value="Label for section (e.g. for ToC)" />
<definition value="The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents." />
<comment value="The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." />
<requirements value="Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized." />
<alias value="header" />
<alias value="label" />
<alias value="caption" />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.title" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./title" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".title" />
</mapping>
</element>
<element id="Composition.section:sectionPlanOfCare.code">
<path value="Composition.section.code" />
<short value="Classification of section (recommended)" />
<definition value="A code identifying the kind of content contained within the section. This must be consistent with the section title." />
<comment value="The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." />
<requirements value="Provides computable standardized labels to topics within the document." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="18776-5" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CompositionSectionType" />
</extension>
<strength value="example" />
<description value="Classification of a section of a composition/document." />
<valueSet value="http://hl7.org/fhir/ValueSet/doc-section-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
</element>
<element id="Composition.section:sectionPlanOfCare.author">
<path value="Composition.section.author" />
<short value="Who and/or what authored the section" />
<definition value="Identifies who is responsible for the information in this section, not necessarily who typed it in." />
<requirements value="Identifies who is responsible for the content." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.author" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".author.assignedAuthor" />
</mapping>
</element>
<element id="Composition.section:sectionPlanOfCare.focus">
<path value="Composition.section.focus" />
<short value="Who/what the section is about, when it is not about the subject of composition" />
<definition value="The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources)." />
<comment value="Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.focus" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="cda" />
<map value=".subject? (CDA did not differentiate between subject and focus)" />
</mapping>
</element>
<element id="Composition.section:sectionPlanOfCare.text">
<path value="Composition.section.text" />
<short value="Text summary of the section, for human interpretation" />
<definition value="A human-readable narrative that contains the attested content of the section, 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." />
<comment value="Document profiles may define what content should be represented in the narrative to ensure clinical safety." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".text" />
</mapping>
</element>
<element id="Composition.section:sectionPlanOfCare.mode">
<path value="Composition.section.mode" />
<short value="working | snapshot | changes" />
<definition value="How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted." />
<comment value="This element is labeled as a modifier because a change list must not be misunderstood as a complete list." />
<requirements value="Sections are used in various ways, and it must be known in what way it is safe to use the entries in them." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.mode" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionMode" />
</extension>
<strength value="required" />
<description value="The processing mode that applies to this section." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-mode|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPlanOfCare.orderedBy">
<path value="Composition.section.orderedBy" />
<short value="Order of section entries" />
<definition value="Specifies the order applied to the items in the section entries." />
<comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order." />
<requirements value="Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.orderedBy" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEntryOrder" />
</extension>
<strength value="preferred" />
<description value="What order applies to the items in the entry." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-order" />
</binding>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP].sequenceNumber > 1" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPlanOfCare.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Optional entry used to represent structured care plans" />
<definition value="Dynamic, personalized plan including identified needed healthcare activity, health objectives and healthcare goals, relating to one or more specified health issues in a healthcare process [Source EN ISO 13940]" />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionPlanOfCare.entry:carePlan">
<path value="Composition.section.entry" />
<sliceName value="carePlan" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionPlanOfCare.entry:documentReference">
<path value="Composition.section.entry" />
<sliceName value="documentReference" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionPlanOfCare.emptyReason">
<path value="Composition.section.emptyReason" />
<short value="Why the section is empty" />
<definition value="If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason." />
<comment value="The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases." />
<requirements value="Allows capturing things like "none exist" or "not asked" which can be important for most lists." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEmptyReason" />
</extension>
<strength value="preferred" />
<description value="If a section is empty, why it is empty." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-empty-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPlanOfCare.section">
<path value="Composition.section.section" />
<short value="Nested Section" />
<definition value="A nested sub-section within this section." />
<comment value="Nested sections are primarily used to help human readers navigate to particular portions of the document." />
<min value="0" />
<max value="0" />
<base>
<path value="Composition.section.section" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" />
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.section" />
</mapping>
</element>
<element id="Composition.section:sectionSocialHistory">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionSocialHistory" />
<short value="PS-CA Social History Section" />
<definition value="The social history section contains a description of the person’s Health related "lifestyle factors" or "lifestyle observations" (e.g., smoke habits; alcohol consumption; diets, risky habits.)" />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content" />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="cmp-1" />
<severity value="error" />
<human value="A section must contain at least one of text, entries, or sub-sections" />
<expression value="text.exists() or entry.exists() or section.exists()" />
<xpath value="exists(f:text) or exists(f:entry) or exists(f:section)" />
</constraint>
<constraint>
<key value="cmp-2" />
<severity value="error" />
<human value="A section can only have an emptyReason if it is empty" />
<expression value="emptyReason.empty() or entry.empty()" />
<xpath value="not(exists(f:emptyReason) and exists(f:entry))" />
</constraint>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.structuredBody.component.section" />
</mapping>
</element>
<element id="Composition.section:sectionSocialHistory.id">
<path value="Composition.section.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionSocialHistory.extension">
<path value="Composition.section.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionSocialHistory.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<comment value="This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element" />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionSocialHistory.modifierExtension">
<path value="Composition.section.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.section:sectionSocialHistory.title">
<path value="Composition.section.title" />
<short value="Label for section (e.g. for ToC)" />
<definition value="The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents." />
<comment value="The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." />
<requirements value="Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized." />
<alias value="header" />
<alias value="label" />
<alias value="caption" />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.title" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./title" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".title" />
</mapping>
</element>
<element id="Composition.section:sectionSocialHistory.code">
<path value="Composition.section.code" />
<short value="Classification of section (recommended)" />
<definition value="A code identifying the kind of content contained within the section. This must be consistent with the section title." />
<comment value="The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." />
<requirements value="Provides computable standardized labels to topics within the document." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="29762-2" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CompositionSectionType" />
</extension>
<strength value="example" />
<description value="Classification of a section of a composition/document." />
<valueSet value="http://hl7.org/fhir/ValueSet/doc-section-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
</element>
<element id="Composition.section:sectionSocialHistory.author">
<path value="Composition.section.author" />
<short value="Who and/or what authored the section" />
<definition value="Identifies who is responsible for the information in this section, not necessarily who typed it in." />
<requirements value="Identifies who is responsible for the content." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.author" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".author.assignedAuthor" />
</mapping>
</element>
<element id="Composition.section:sectionSocialHistory.focus">
<path value="Composition.section.focus" />
<short value="Who/what the section is about, when it is not about the subject of composition" />
<definition value="The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources)." />
<comment value="Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.focus" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="cda" />
<map value=".subject? (CDA did not differentiate between subject and focus)" />
</mapping>
</element>
<element id="Composition.section:sectionSocialHistory.text">
<path value="Composition.section.text" />
<short value="Text summary of the section, for human interpretation" />
<definition value="A human-readable narrative that contains the attested content of the section, 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." />
<comment value="Document profiles may define what content should be represented in the narrative to ensure clinical safety." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".text" />
</mapping>
</element>
<element id="Composition.section:sectionSocialHistory.mode">
<path value="Composition.section.mode" />
<short value="working | snapshot | changes" />
<definition value="How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted." />
<comment value="This element is labeled as a modifier because a change list must not be misunderstood as a complete list." />
<requirements value="Sections are used in various ways, and it must be known in what way it is safe to use the entries in them." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.mode" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionMode" />
</extension>
<strength value="required" />
<description value="The processing mode that applies to this section." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-mode|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionSocialHistory.orderedBy">
<path value="Composition.section.orderedBy" />
<short value="Order of section entries" />
<definition value="Specifies the order applied to the items in the section entries." />
<comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order." />
<requirements value="Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.orderedBy" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEntryOrder" />
</extension>
<strength value="preferred" />
<description value="What order applies to the items in the entry." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-order" />
</binding>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP].sequenceNumber > 1" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionSocialHistory.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Health related "lifestyle factors" or "lifestyle observations" (e.g., smoke habits; alcohol consumption; diets, risky habits.)" />
<definition value="Description of the person’s Health related “lifestyle factors" or "lifestyle observations" (e.g., smoke habits; alcohol consumption; diets, risky habits.)" />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionSocialHistory.entry:generalSocialHistory">
<path value="Composition.section.entry" />
<sliceName value="generalSocialHistory" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-socialhistory-ca-ps" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionSocialHistory.entry:smokingTobaccoUse">
<path value="Composition.section.entry" />
<sliceName value="smokingTobaccoUse" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-tobaccouse-ca-ps" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionSocialHistory.entry:alcoholUse">
<path value="Composition.section.entry" />
<sliceName value="alcoholUse" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-alcoholuse-ca-ps" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionSocialHistory.emptyReason">
<path value="Composition.section.emptyReason" />
<short value="Why the section is empty" />
<definition value="If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason." />
<comment value="The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases." />
<requirements value="Allows capturing things like "none exist" or "not asked" which can be important for most lists." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEmptyReason" />
</extension>
<strength value="preferred" />
<description value="If a section is empty, why it is empty." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-empty-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionSocialHistory.section">
<path value="Composition.section.section" />
<short value="Nested Section" />
<definition value="A nested sub-section within this section." />
<comment value="Nested sections are primarily used to help human readers navigate to particular portions of the document." />
<min value="0" />
<max value="0" />
<base>
<path value="Composition.section.section" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" />
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.section" />
</mapping>
</element>
<element id="Composition.section:sectionPregnancyHx">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionPregnancyHx" />
<short value="PS-CA History of Pregnancy Section" />
<definition value="The history of pregnancy section shall contain information about whether the patient is currently pregnant or not.\nIt may contain addition summarizing information about the outcome of earlier pregnancies." />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="cmp-1" />
<severity value="error" />
<human value="A section must contain at least one of text, entries, or sub-sections" />
<expression value="text.exists() or entry.exists() or section.exists()" />
<xpath value="exists(f:text) or exists(f:entry) or exists(f:section)" />
</constraint>
<constraint>
<key value="cmp-2" />
<severity value="error" />
<human value="A section can only have an emptyReason if it is empty" />
<expression value="emptyReason.empty() or entry.empty()" />
<xpath value="not(exists(f:emptyReason) and exists(f:entry))" />
</constraint>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.structuredBody.component.section" />
</mapping>
</element>
<element id="Composition.section:sectionPregnancyHx.id">
<path value="Composition.section.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPregnancyHx.extension">
<path value="Composition.section.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPregnancyHx.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<comment value="This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element" />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPregnancyHx.modifierExtension">
<path value="Composition.section.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.section:sectionPregnancyHx.title">
<path value="Composition.section.title" />
<short value="Label for section (e.g. for ToC)" />
<definition value="The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents." />
<comment value="The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." />
<requirements value="Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized." />
<alias value="header" />
<alias value="label" />
<alias value="caption" />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.title" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./title" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".title" />
</mapping>
</element>
<element id="Composition.section:sectionPregnancyHx.code">
<path value="Composition.section.code" />
<short value="Classification of section (recommended)" />
<definition value="A code identifying the kind of content contained within the section. This must be consistent with the section title." />
<comment value="The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." />
<requirements value="Provides computable standardized labels to topics within the document." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="10162-6" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CompositionSectionType" />
</extension>
<strength value="example" />
<description value="Classification of a section of a composition/document." />
<valueSet value="http://hl7.org/fhir/ValueSet/doc-section-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
</element>
<element id="Composition.section:sectionPregnancyHx.author">
<path value="Composition.section.author" />
<short value="Who and/or what authored the section" />
<definition value="Identifies who is responsible for the information in this section, not necessarily who typed it in." />
<requirements value="Identifies who is responsible for the content." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.author" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".author.assignedAuthor" />
</mapping>
</element>
<element id="Composition.section:sectionPregnancyHx.focus">
<path value="Composition.section.focus" />
<short value="Who/what the section is about, when it is not about the subject of composition" />
<definition value="The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources)." />
<comment value="Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.focus" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="cda" />
<map value=".subject? (CDA did not differentiate between subject and focus)" />
</mapping>
</element>
<element id="Composition.section:sectionPregnancyHx.text">
<path value="Composition.section.text" />
<short value="Text summary of the section, for human interpretation" />
<definition value="A human-readable narrative that contains the attested content of the section, 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." />
<comment value="Document profiles may define what content should be represented in the narrative to ensure clinical safety." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".text" />
</mapping>
</element>
<element id="Composition.section:sectionPregnancyHx.mode">
<path value="Composition.section.mode" />
<short value="working | snapshot | changes" />
<definition value="How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted." />
<comment value="This element is labeled as a modifier because a change list must not be misunderstood as a complete list." />
<requirements value="Sections are used in various ways, and it must be known in what way it is safe to use the entries in them." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.mode" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionMode" />
</extension>
<strength value="required" />
<description value="The processing mode that applies to this section." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-mode|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPregnancyHx.orderedBy">
<path value="Composition.section.orderedBy" />
<short value="Order of section entries" />
<definition value="Specifies the order applied to the items in the section entries." />
<comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order." />
<requirements value="Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.orderedBy" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEntryOrder" />
</extension>
<strength value="preferred" />
<description value="What order applies to the items in the entry." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-order" />
</binding>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP].sequenceNumber > 1" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPregnancyHx.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Current pregnancy status and, optionally, information about the outcome of earlier pregnancies." />
<definition value="It contains information about whether the patient is currently pregnant or not.\nIt may contain addition summarizing information about the outcome of earlier pregnancies." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionPregnancyHx.entry:pregnancyStatus">
<path value="Composition.section.entry" />
<sliceName value="pregnancyStatus" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="Pending definition of a PS CA pregnancy status observation profile in a future release of PS CA, implementors are encouraged to use the IPS pregnancy status observation profile." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/uv/ips/StructureDefinition/Observation-pregnancy-status-uv-ips" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionPregnancyHx.entry:pregnancyOutcomeSummary">
<path value="Composition.section.entry" />
<sliceName value="pregnancyOutcomeSummary" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="Pending definition of a PS CA pregnancy outcome observation profile in a future release of PS CA, implementors are encouraged to use the IPS pregnancy outcome observation profile." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/uv/ips/StructureDefinition/Observation-pregnancy-outcome-uv-ips" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionPregnancyHx.emptyReason">
<path value="Composition.section.emptyReason" />
<short value="Why the section is empty" />
<definition value="If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason." />
<comment value="The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases." />
<requirements value="Allows capturing things like "none exist" or "not asked" which can be important for most lists." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEmptyReason" />
</extension>
<strength value="preferred" />
<description value="If a section is empty, why it is empty." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-empty-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPregnancyHx.section">
<path value="Composition.section.section" />
<short value="Nested Section" />
<definition value="A nested sub-section within this section." />
<comment value="Nested sections are primarily used to help human readers navigate to particular portions of the document." />
<min value="0" />
<max value="0" />
<base>
<path value="Composition.section.section" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" />
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.section" />
</mapping>
</element>
<element id="Composition.section:sectionAdvanceDirectives">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionAdvanceDirectives" />
<short value="PS-CA Advance Directives Section" />
<definition value="The advance directives section contains a narrative description of patient's advance directive." />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="cmp-1" />
<severity value="error" />
<human value="A section must contain at least one of text, entries, or sub-sections" />
<expression value="text.exists() or entry.exists() or section.exists()" />
<xpath value="exists(f:text) or exists(f:entry) or exists(f:section)" />
</constraint>
<constraint>
<key value="cmp-2" />
<severity value="error" />
<human value="A section can only have an emptyReason if it is empty" />
<expression value="emptyReason.empty() or entry.empty()" />
<xpath value="not(exists(f:emptyReason) and exists(f:entry))" />
</constraint>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.structuredBody.component.section" />
</mapping>
</element>
<element id="Composition.section:sectionAdvanceDirectives.id">
<path value="Composition.section.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionAdvanceDirectives.extension">
<path value="Composition.section.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionAdvanceDirectives.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<comment value="This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element" />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionAdvanceDirectives.modifierExtension">
<path value="Composition.section.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.section:sectionAdvanceDirectives.title">
<path value="Composition.section.title" />
<short value="Label for section (e.g. for ToC)" />
<definition value="The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents." />
<comment value="The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." />
<requirements value="Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized." />
<alias value="header" />
<alias value="label" />
<alias value="caption" />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.title" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./title" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".title" />
</mapping>
</element>
<element id="Composition.section:sectionAdvanceDirectives.code">
<path value="Composition.section.code" />
<short value="Classification of section (recommended)" />
<definition value="A code identifying the kind of content contained within the section. This must be consistent with the section title." />
<comment value="The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." />
<requirements value="Provides computable standardized labels to topics within the document." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="42348-3" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CompositionSectionType" />
</extension>
<strength value="example" />
<description value="Classification of a section of a composition/document." />
<valueSet value="http://hl7.org/fhir/ValueSet/doc-section-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
</element>
<element id="Composition.section:sectionAdvanceDirectives.author">
<path value="Composition.section.author" />
<short value="Who and/or what authored the section" />
<definition value="Identifies who is responsible for the information in this section, not necessarily who typed it in." />
<requirements value="Identifies who is responsible for the content." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.author" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".author.assignedAuthor" />
</mapping>
</element>
<element id="Composition.section:sectionAdvanceDirectives.focus">
<path value="Composition.section.focus" />
<short value="Who/what the section is about, when it is not about the subject of composition" />
<definition value="The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources)." />
<comment value="Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.focus" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="cda" />
<map value=".subject? (CDA did not differentiate between subject and focus)" />
</mapping>
</element>
<element id="Composition.section:sectionAdvanceDirectives.text">
<path value="Composition.section.text" />
<short value="Text summary of the section, for human interpretation" />
<definition value="A human-readable narrative that contains the attested content of the section, 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." />
<comment value="Document profiles may define what content should be represented in the narrative to ensure clinical safety." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".text" />
</mapping>
</element>
<element id="Composition.section:sectionAdvanceDirectives.mode">
<path value="Composition.section.mode" />
<short value="working | snapshot | changes" />
<definition value="How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted." />
<comment value="This element is labeled as a modifier because a change list must not be misunderstood as a complete list." />
<requirements value="Sections are used in various ways, and it must be known in what way it is safe to use the entries in them." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.mode" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionMode" />
</extension>
<strength value="required" />
<description value="The processing mode that applies to this section." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-mode|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionAdvanceDirectives.orderedBy">
<path value="Composition.section.orderedBy" />
<short value="Order of section entries" />
<definition value="Specifies the order applied to the items in the section entries." />
<comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order." />
<requirements value="Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.orderedBy" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEntryOrder" />
</extension>
<strength value="preferred" />
<description value="What order applies to the items in the entry." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-order" />
</binding>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP].sequenceNumber > 1" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionAdvanceDirectives.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Narrative description of the patient's advance directive." />
<definition value="Contains a narrative description or a Consent entry with information about the patient's advance directive." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent">
<path value="Composition.section.entry" />
<sliceName value="advanceDirectivesConsent" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Consent" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesDocumentReference">
<path value="Composition.section.entry" />
<sliceName value="advanceDirectivesDocumentReference" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionAdvanceDirectives.emptyReason">
<path value="Composition.section.emptyReason" />
<short value="Why the section is empty" />
<definition value="If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason." />
<comment value="The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases." />
<requirements value="Allows capturing things like "none exist" or "not asked" which can be important for most lists." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEmptyReason" />
</extension>
<strength value="preferred" />
<description value="If a section is empty, why it is empty." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-empty-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionAdvanceDirectives.section">
<path value="Composition.section.section" />
<short value="Nested Section" />
<definition value="A nested sub-section within this section." />
<comment value="Nested sections are primarily used to help human readers navigate to particular portions of the document." />
<min value="0" />
<max value="0" />
<base>
<path value="Composition.section.section" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" />
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.section" />
</mapping>
</element>
<element id="Composition.section:sectionFamilyHistory">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionFamilyHistory" />
<short value="PS-CA Family History Section" />
<definition value="The family history section contains a description of the patient's family history." />
<comment value="This is a new section being introduced by the PS-CA specification at the request of jurisdictions." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="cmp-1" />
<severity value="error" />
<human value="A section must contain at least one of text, entries, or sub-sections" />
<expression value="text.exists() or entry.exists() or section.exists()" />
<xpath value="exists(f:text) or exists(f:entry) or exists(f:section)" />
</constraint>
<constraint>
<key value="cmp-2" />
<severity value="error" />
<human value="A section can only have an emptyReason if it is empty" />
<expression value="emptyReason.empty() or entry.empty()" />
<xpath value="not(exists(f:emptyReason) and exists(f:entry))" />
</constraint>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.structuredBody.component.section" />
</mapping>
</element>
<element id="Composition.section:sectionFamilyHistory.id">
<path value="Composition.section.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionFamilyHistory.extension">
<path value="Composition.section.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionFamilyHistory.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<comment value="This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element" />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionFamilyHistory.modifierExtension">
<path value="Composition.section.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.section:sectionFamilyHistory.title">
<path value="Composition.section.title" />
<short value="Label for section (e.g. for ToC)" />
<definition value="The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents." />
<comment value="The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." />
<requirements value="Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized." />
<alias value="header" />
<alias value="label" />
<alias value="caption" />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.title" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./title" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".title" />
</mapping>
</element>
<element id="Composition.section:sectionFamilyHistory.code">
<path value="Composition.section.code" />
<short value="Classification of section (recommended)" />
<definition value="A code identifying the kind of content contained within the section. This must be consistent with the section title." />
<comment value="The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." />
<requirements value="Provides computable standardized labels to topics within the document." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="10157-6" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CompositionSectionType" />
</extension>
<strength value="example" />
<description value="Classification of a section of a composition/document." />
<valueSet value="http://hl7.org/fhir/ValueSet/doc-section-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
</element>
<element id="Composition.section:sectionFamilyHistory.author">
<path value="Composition.section.author" />
<short value="Who and/or what authored the section" />
<definition value="Identifies who is responsible for the information in this section, not necessarily who typed it in." />
<requirements value="Identifies who is responsible for the content." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.author" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".author.assignedAuthor" />
</mapping>
</element>
<element id="Composition.section:sectionFamilyHistory.focus">
<path value="Composition.section.focus" />
<short value="Who/what the section is about, when it is not about the subject of composition" />
<definition value="The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources)." />
<comment value="Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.focus" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="cda" />
<map value=".subject? (CDA did not differentiate between subject and focus)" />
</mapping>
</element>
<element id="Composition.section:sectionFamilyHistory.text">
<path value="Composition.section.text" />
<short value="Text summary of the section, for human interpretation" />
<definition value="A human-readable narrative that contains the attested content of the section, 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." />
<comment value="Document profiles may define what content should be represented in the narrative to ensure clinical safety." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".text" />
</mapping>
</element>
<element id="Composition.section:sectionFamilyHistory.mode">
<path value="Composition.section.mode" />
<short value="working | snapshot | changes" />
<definition value="How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted." />
<comment value="This element is labeled as a modifier because a change list must not be misunderstood as a complete list." />
<requirements value="Sections are used in various ways, and it must be known in what way it is safe to use the entries in them." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.mode" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionMode" />
</extension>
<strength value="required" />
<description value="The processing mode that applies to this section." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-mode|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionFamilyHistory.orderedBy">
<path value="Composition.section.orderedBy" />
<short value="Order of section entries" />
<definition value="Specifies the order applied to the items in the section entries." />
<comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order." />
<requirements value="Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.orderedBy" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEntryOrder" />
</extension>
<strength value="preferred" />
<description value="What order applies to the items in the entry." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-order" />
</binding>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP].sequenceNumber > 1" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionFamilyHistory.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Narrative description of the patient's family history." />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionFamilyHistory.entry:FamilyMemberHistory">
<path value="Composition.section.entry" />
<sliceName value="FamilyMemberHistory" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/familymemberhistory-ca-ps" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionFamilyHistory.emptyReason">
<path value="Composition.section.emptyReason" />
<short value="Why the section is empty" />
<definition value="If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason." />
<comment value="The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases." />
<requirements value="Allows capturing things like "none exist" or "not asked" which can be important for most lists." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEmptyReason" />
</extension>
<strength value="preferred" />
<description value="If a section is empty, why it is empty." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-empty-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionFamilyHistory.section">
<path value="Composition.section.section" />
<short value="Nested Section" />
<definition value="A nested sub-section within this section." />
<comment value="Nested sections are primarily used to help human readers navigate to particular portions of the document." />
<min value="0" />
<max value="0" />
<base>
<path value="Composition.section.section" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" />
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.section" />
</mapping>
</element>
<element id="Composition.section:sectionPatientStory">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionPatientStory" />
<short value="PS-CA Patient Story Section" />
<definition value="The section contains narrative text along with optional resources that express what matters to a patient. This may include needs, strengths, values, concerns and preferences to others providing support and care. The patient’s story, provided here, may be told by the patient or by a proxy." />
<comment value="This is a new section being introduced by the PS-CA specification at the request of jurisdictions. While the Patient Story section is relatively unconstrained at this time, information that is better suited to another section should not be included in the Patient Story. For example, DNR orders should be placed in the Advanced Directives section." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="cmp-1" />
<severity value="error" />
<human value="A section must contain at least one of text, entries, or sub-sections" />
<expression value="text.exists() or entry.exists() or section.exists()" />
<xpath value="exists(f:text) or exists(f:entry) or exists(f:section)" />
</constraint>
<constraint>
<key value="cmp-2" />
<severity value="error" />
<human value="A section can only have an emptyReason if it is empty" />
<expression value="emptyReason.empty() or entry.empty()" />
<xpath value="not(exists(f:emptyReason) and exists(f:entry))" />
</constraint>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.structuredBody.component.section" />
</mapping>
</element>
<element id="Composition.section:sectionPatientStory.id">
<path value="Composition.section.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPatientStory.extension">
<path value="Composition.section.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPatientStory.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<comment value="This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element" />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPatientStory.modifierExtension">
<path value="Composition.section.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Composition.section:sectionPatientStory.title">
<path value="Composition.section.title" />
<short value="Label for section (e.g. for ToC)" />
<definition value="The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents." />
<comment value="The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." />
<requirements value="Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized." />
<alias value="header" />
<alias value="label" />
<alias value="caption" />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.title" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./title" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".title" />
</mapping>
</element>
<element id="Composition.section:sectionPatientStory.code">
<path value="Composition.section.code" />
<short value="Classification of section (recommended)" />
<definition value="A code identifying the kind of content contained within the section. This must be consistent with the section title." />
<comment value="The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." />
<requirements value="Provides computable standardized labels to topics within the document." />
<min value="1" />
<max value="1" />
<base>
<path value="Composition.section.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="81338-6" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CompositionSectionType" />
</extension>
<strength value="example" />
<description value="Classification of a section of a composition/document." />
<valueSet value="http://hl7.org/fhir/ValueSet/doc-section-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".code" />
</mapping>
</element>
<element id="Composition.section:sectionPatientStory.author">
<path value="Composition.section.author" />
<short value="Who and/or what authored the section" />
<definition value="Identifies who is responsible for the information in this section, not necessarily who typed it in." />
<requirements value="Identifies who is responsible for the content." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.author" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".author.assignedAuthor" />
</mapping>
</element>
<element id="Composition.section:sectionPatientStory.focus">
<path value="Composition.section.focus" />
<short value="Who/what the section is about, when it is not about the subject of composition" />
<definition value="The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources)." />
<comment value="Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.focus" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="cda" />
<map value=".subject? (CDA did not differentiate between subject and focus)" />
</mapping>
</element>
<element id="Composition.section:sectionPatientStory.text">
<path value="Composition.section.text" />
<short value="Text summary of the section, for human interpretation" />
<definition value="A human-readable narrative that contains the attested content of the section, 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." />
<comment value="Document profiles may define what content should be represented in the narrative to ensure clinical safety." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".text" />
</mapping>
</element>
<element id="Composition.section:sectionPatientStory.mode">
<path value="Composition.section.mode" />
<short value="working | snapshot | changes" />
<definition value="How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted." />
<comment value="This element is labeled as a modifier because a change list must not be misunderstood as a complete list." />
<requirements value="Sections are used in various ways, and it must be known in what way it is safe to use the entries in them." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.mode" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionMode" />
</extension>
<strength value="required" />
<description value="The processing mode that applies to this section." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-mode|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPatientStory.orderedBy">
<path value="Composition.section.orderedBy" />
<short value="Order of section entries" />
<definition value="Specifies the order applied to the items in the section entries." />
<comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order." />
<requirements value="Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.orderedBy" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEntryOrder" />
</extension>
<strength value="preferred" />
<description value="What order applies to the items in the entry." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-order" />
</binding>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP].sequenceNumber > 1" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPatientStory.entry">
<path value="Composition.section.entry" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<comment value="If there are no entries in the list, an emptyReason SHOULD be provided." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.entry" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".entry" />
</mapping>
</element>
<element id="Composition.section:sectionPatientStory.emptyReason">
<path value="Composition.section.emptyReason" />
<short value="Why the section is empty" />
<definition value="If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason." />
<comment value="The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases." />
<requirements value="Allows capturing things like "none exist" or "not asked" which can be important for most lists." />
<min value="0" />
<max value="1" />
<base>
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="cmp-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SectionEmptyReason" />
</extension>
<strength value="preferred" />
<description value="If a section is empty, why it is empty." />
<valueSet value="http://hl7.org/fhir/ValueSet/list-empty-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Composition.section:sectionPatientStory.section">
<path value="Composition.section.section" />
<short value="Nested Section" />
<definition value="A nested sub-section within this section." />
<comment value="Nested sections are primarily used to help human readers navigate to particular portions of the document." />
<min value="0" />
<max value="*" />
<base>
<path value="Composition.section.section" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" />
<condition value="cmp-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".component.section" />
</mapping>
</element>
</snapshot>
<differential>
<element id="Composition">
<path value="Composition" />
<short value="Canadian Patient Summary composition" />
<definition value="Canadian Patient Summary composition.\nA composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement.\nWhile a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained." />
</element>
<element id="Composition.text">
<path value="Composition.text" />
<comment value="PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text." />
<mustSupport value="true" />
</element>
<element id="Composition.identifier">
<path value="Composition.identifier" />
<mustSupport value="true" />
</element>
<element id="Composition.status">
<path value="Composition.status" />
<mustSupport value="true" />
</element>
<element id="Composition.type">
<path value="Composition.type" />
<short value="Kind of composition ("Patient Summary")" />
<definition value="Specifies that this composition refers to a Patient Summary (Loinc "60591-5")" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="60591-5" />
</coding>
</patternCodeableConcept>
<mustSupport value="true" />
</element>
<element id="Composition.subject">
<path value="Composition.subject" />
<definition value="Who or what the composition is about.\nIn general a composition 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 livestock, or a set of patients that share a common exposure).\nFor the PS the subject is always the patient." />
<min value="1" />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps" />
</type>
<mustSupport value="true" />
</element>
<element id="Composition.subject.reference">
<path value="Composition.subject.reference" />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.encounter">
<path value="Composition.encounter" />
<comment value="While IPS-UV considers this a Must Support element, policy has not yet been developed in Canada confirming the expectations for when a patient summary is created (e.g., does it have to be created by a health professional or just validated, can it be automatically assembled, does it have to occur within an encounter, etc.). This relaxation does not exclude or prevent implementers from further defining how encounter is used in their implementation if their use case(s) rely on its presence." />
</element>
<element id="Composition.date">
<path value="Composition.date" />
<mustSupport value="true" />
</element>
<element id="Composition.author">
<path value="Composition.author" />
<short value="Who and/or what authored the patient summary" />
<definition value="Identifies who is responsible for the information in the patient summary, not necessarily who typed it in.\n\nThe type of author(s) contribute to determine the "nature"of the Patient Summary: e.g., a "human-curated" PS Vs. an "automatically generated" PS." />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner" />
<targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization" />
</type>
<mustSupport value="true" />
</element>
<element id="Composition.title">
<path value="Composition.title" />
<short value="CA Patient Summary" />
<definition value="Official human-readable label for the composition.\n\nFor this document should be "CA Patient Summary" or any equivalent translation" />
<mustSupport value="true" />
</element>
<element id="Composition.confidentiality">
<path value="Composition.confidentiality" />
</element>
<element id="Composition.attester">
<path value="Composition.attester" />
<comment value="IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported across workflows of Canadian jurisdictional implementers. \n\n These challenges have been raised in IPS. Further assessment of jurisdictional use cases need to be explored by the Patient Summary Working Group before the constraint will be re-considered for inclusion" />
</element>
<element id="Composition.attester.mode">
<path value="Composition.attester.mode" />
<comment value="While Composition.attester is not currently flagged as Must Support in PS-CA, Implementers who support attester are expected to support attester.mode, attester.time, and attester.party" />
<mustSupport value="true" />
</element>
<element id="Composition.attester.time">
<path value="Composition.attester.time" />
<comment value="While Composition.attester is not currently flagged as Must Support in PS-CA, Implementers who support attester are expected to support attester.mode, attester.time, and attester.party" />
<mustSupport value="true" />
</element>
<element id="Composition.attester.party">
<path value="Composition.attester.party" />
<comment value="While Composition.attester is not currently flagged as Must Support in PS-CA, Implementers who support attester are expected to support attester.mode, attester.time, and attester.party" />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner" />
<targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole" />
<targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization" />
</type>
<mustSupport value="true" />
</element>
<element id="Composition.custodian">
<path value="Composition.custodian" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization" />
</type>
<mustSupport value="true" />
</element>
<element id="Composition.relatesTo">
<path value="Composition.relatesTo" />
</element>
<element id="Composition.relatesTo.code">
<path value="Composition.relatesTo.code" />
</element>
<element id="Composition.relatesTo.target[x]">
<path value="Composition.relatesTo.target[x]" />
<type>
<code value="Identifier" />
</type>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Composition" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps" />
</type>
</element>
<element id="Composition.event">
<path value="Composition.event" />
<slicing>
<discriminator>
<type value="pattern" />
<path value="code" />
</discriminator>
<rules value="open" />
</slicing>
<definition value="IPS Note: The main activity being described by a PS is the provision of healthcare over a period of time. In the CDA representation of the PS this is shown by setting the value of serviceEvent/@classCode to “PCPR” (care provision) and indicating the duration over which care was provided in serviceEvent/effectiveTime. In the FHIR representation at least one event should be used to record this information. Additional data from outside this duration may also be included if it is relevant to care provided during that time range (e.g., reviewed during the stated time range). For example if the PS is generated by a GP based on information recorded in his/her EHR-S, then the start value should represent the date when the treatment relationship between the patient and the GP started; and the end value the date of the latest care event." />
</element>
<element id="Composition.event:careProvisioningEvent">
<path value="Composition.event" />
<sliceName value="careProvisioningEvent" />
<short value="The care provisioning being documented" />
<definition value="The provision of healthcare over a period of time this PS is documented." />
<max value="1" />
</element>
<element id="Composition.event:careProvisioningEvent.code">
<path value="Composition.event.code" />
<comment value="While Composition.event:careProvisioningEvent slice is not currently flagged as Must Support in PS-CA, Implementers who support the slice are expected to support Composition.event:careProvisioningEvent.code and Composition.event:careProvisioningEvent.period" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActClass" />
<code value="PCPR" />
</coding>
</patternCodeableConcept>
<mustSupport value="true" />
</element>
<element id="Composition.event:careProvisioningEvent.period">
<path value="Composition.event.period" />
<comment value="While Composition.event:careProvisioningEvent slice is not currently flagged as Must Support in PS-CA, Implementers who support the slice are expected to support Composition.event:careProvisioningEvent.code and Composition.event:careProvisioningEvent.period" />
<mustSupport value="true" />
</element>
<element id="Composition.section">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<slicing>
<discriminator>
<type value="pattern" />
<path value="code" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Sections composing the PS" />
<definition value="The root of the sections that make up the PS-CA composition." />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section.extension">
<path value="Composition.section.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
</element>
<element id="Composition.section.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
</element>
<element id="Composition.section.code">
<path value="Composition.section.code" />
<min value="1" />
<type>
<code value="CodeableConcept" />
<profile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" />
</type>
<mustSupport value="true" />
</element>
<element id="Composition.section.text">
<path value="Composition.section.text" />
<comment value="PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text." />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section.emptyReason">
<path value="Composition.section.emptyReason" />
</element>
<element id="Composition.section:sectionMedications">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionMedications" />
<short value="PS-CA Medication Summary Section" />
<definition value="The medication summary section contains a description of the patient's medications relevant for the scope of the patient summary. The actual content could depend on the jurisdiction, it could report:\n- the currently active medications;\n- the current and past medications considered relevant by the authoring GP;\n- the patient prescriptions or dispensations automatically extracted by a regional or a national EHR.\n\nBecause This section has been expanded in the PS-CA to model a medicationRequest profile in addition to medicationStatement profile initially included in IPS-UV." />
<comment value="IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of data - though has recently updated to allow for the provision of section.emptyReason. This constraint has been maintained in the PS-CA. Systems should utilize the section.entry with a resource when conveying that the subject has no known medications (e.g., clinical assertions that are captured alongside supportive data like date). The section.emptyReason is available to convey details for why the section entry is empty (e.g., data unavailable)." />
<min value="1" />
<max value="1" />
<constraint>
<key value="ips-comp-1" />
<severity value="error" />
<human value="Either section.entry or emptyReason are present" />
<expression value="(entry.reference.exists() or emptyReason.exists())" />
<xpath value="(/f:entry.reference and not /f:emptyReason) or (not(/f:emptyReason) and /f:entry.reference)" />
</constraint>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionMedications.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
</element>
<element id="Composition.section:sectionMedications.title">
<path value="Composition.section.title" />
<short value="Medication Summary section" />
<definition value="The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.\n\nMedication Summary" />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionMedications.code">
<path value="Composition.section.code" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="10160-0" />
</coding>
</patternCodeableConcept>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionMedications.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Medications relevant for the scope of the patient summary" />
<definition value="This list the medications relevant for the scope of the patient summary or it is used to indicate that the subject is known not to be on any relevant medication" />
<comment value="This entry requires a medicationStatement or a medicationRequest." />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionMedications.entry:medicationStatement">
<path value="Composition.section.entry" />
<sliceName value="medicationStatement" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/medicationstatement-ca-ps" />
</type>
</element>
<element id="Composition.section:sectionMedications.entry:medicationRequest">
<path value="Composition.section.entry" />
<sliceName value="medicationRequest" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/medicationrequest-ca-ps" />
</type>
</element>
<element id="Composition.section:sectionMedications.emptyReason">
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionMedications.section">
<path value="Composition.section.section" />
<max value="0" />
</element>
<element id="Composition.section:sectionAllergies">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionAllergies" />
<short value="PS-CA Allergies and Intolerances Section" />
<definition value="This section documents the relevant allergies or intolerances (conditions) for that patient, describing the kind of reaction (e.g., rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy.\nAt a minimum, it should list currently active and any relevant historical allergies and adverse reactions.\nIf no information about allergies is available, or if no allergies are known this should be clearly documented in the section." />
<comment value="IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of data - though has recently updated to allow for the provision of section.emptyReason. This constraint has been maintained in the PS-CA. Systems should utilize the section.entry with a resource when conveying that the subject has no known allergies (e.g., clinical assertions that are captured alongside supportive data like date). The section.emptyReason is available to convey details for why the section entry is empty (e.g., data unavailable)." />
<min value="1" />
<max value="1" />
<constraint>
<key value="ips-comp-1" />
<severity value="error" />
<human value="Either section.entry or emptyReason are present" />
<expression value="(entry.reference.exists() or emptyReason.exists())" />
<xpath value="(/f:entry.reference and not /f:emptyReason) or (not(/f:emptyReason) and /f:entry.reference)" />
</constraint>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionAllergies.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
</element>
<element id="Composition.section:sectionAllergies.title">
<path value="Composition.section.title" />
<short value="Allergies and Intolerances" />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionAllergies.code">
<path value="Composition.section.code" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="48765-2" />
</coding>
</patternCodeableConcept>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionAllergies.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Relevant allergies or intolerances (conditions) for that patient." />
<definition value="It lists the relevant allergies or intolerances (conditions) for that patient, describing the kind of reaction (e.g., rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy.\nAt a minimum, it should list currently active and any relevant historical allergies and adverse reactions." />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionAllergies.entry:allergyOrIntolerance">
<path value="Composition.section.entry" />
<sliceName value="allergyOrIntolerance" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/allergyintolerance-ca-ps" />
</type>
</element>
<element id="Composition.section:sectionAllergies.emptyReason">
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionAllergies.section">
<path value="Composition.section.section" />
<max value="0" />
</element>
<element id="Composition.section:sectionProblems">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionProblems" />
<short value="PS-CA Problems Section" />
<definition value="The PS problem section lists and describes clinical problems or conditions currently being monitored for the patient." />
<comment value="IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of data - though has recently updated to allow for the provision of section.emptyReason. This constraint has been maintained in the PS-CA. Systems should utilize the section.entry with a resource when conveying that the subject has no known conditions (e.g., clinical assertions that are captured alongside supportive data like date). The section.emptyReason is available to convey details for why the section entry is empty (e.g., data unavailable)." />
<min value="1" />
<max value="1" />
<constraint>
<key value="ips-comp-1" />
<severity value="error" />
<human value="Either section.entry or emptyReason are present" />
<expression value="(entry.reference.exists() or emptyReason.exists())" />
<xpath value="(/f:entry.reference and not /f:emptyReason) or (not(/f:emptyReason) and /f:entry.reference)" />
</constraint>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionProblems.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
</element>
<element id="Composition.section:sectionProblems.title">
<path value="Composition.section.title" />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionProblems.code">
<path value="Composition.section.code" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="11450-4" />
</coding>
</patternCodeableConcept>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionProblems.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Clinical problems or conditions currently being monitored for the patient." />
<definition value="It lists and describes clinical problems or conditions currently being monitored for the patient." />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionProblems.entry:problem">
<path value="Composition.section.entry" />
<sliceName value="problem" />
<short value="A reference to data that supports this section" />
<definition value="A reference to the actual resource from which the narrative in the section is derived." />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/condition-ca-ps" />
</type>
</element>
<element id="Composition.section:sectionProblems.emptyReason">
<path value="Composition.section.emptyReason" />
<min value="0" />
<max value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionProblems.section">
<path value="Composition.section.section" />
<max value="0" />
</element>
<element id="Composition.section:sectionProceduresHx">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionProceduresHx" />
<short value="PS-CA History of Procedures Section" />
<definition value="The History of Procedures Section contains a description of the patient past procedures that are pertinent to the scope of this document.\nProcedures may refer for example to:\n1. Invasive Diagnostic procedure: e.g., Cardiac catheterization; (the results of these procedure are documented in the results section)\n2. Therapeutic procedure: e.g., dialysis;\n3. Surgical procedure: e.g., appendectomy" />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content" />
<max value="1" />
</element>
<element id="Composition.section:sectionProceduresHx.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
</element>
<element id="Composition.section:sectionProceduresHx.title">
<path value="Composition.section.title" />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionProceduresHx.code">
<path value="Composition.section.code" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="47519-4" />
</coding>
</patternCodeableConcept>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionProceduresHx.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Patient past procedures pertinent to the scope of this document." />
<definition value="It lists the patient past procedures that are pertinent to the scope of this document.\nProcedures may refer for example to:\n1. Invasive Diagnostic procedure: e.g., Cardiac catheterization; (the results of these procedure are documented in the results section)\n2. Therapeutic procedure: e.g., dialysis;\n3. Surgical procedure: e.g., appendectomy." />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionProceduresHx.entry:procedure">
<path value="Composition.section.entry" />
<sliceName value="procedure" />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/procedure-ca-ps" />
</type>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionProceduresHx.section">
<path value="Composition.section.section" />
<max value="0" />
</element>
<element id="Composition.section:sectionImmunizations">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionImmunizations" />
<short value="PS-CA Immunizations Section" />
<definition value="The Immunizations Section defines a patient's current immunization status and pertinent immunization history.\nThe primary use case for the Immunization Section is to enable communication of a patient's immunization status.\nThe section includes the current immunization status, and may contain the entire immunization history that is relevant to the period of time being summarized." />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content" />
<max value="1" />
</element>
<element id="Composition.section:sectionImmunizations.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
</element>
<element id="Composition.section:sectionImmunizations.title">
<path value="Composition.section.title" />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionImmunizations.code">
<path value="Composition.section.code" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="11369-6" />
</coding>
</patternCodeableConcept>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionImmunizations.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Patient's immunization status and pertinent history." />
<definition value="It defines the patient's current immunization status and pertinent immunization history.\nThe primary use case for the Immunization Section is to enable communication of a patient's immunization status.\nIt may contain the entire immunization history that is relevant to the period of time being summarized." />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionImmunizations.entry:immunization">
<path value="Composition.section.entry" />
<sliceName value="immunization" />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/immunization-ca-ps" />
</type>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionImmunizations.section">
<path value="Composition.section.section" />
<max value="0" />
</element>
<element id="Composition.section:sectionMedicalDevices">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionMedicalDevices" />
<short value="PS-CA Medical Devices Section" />
<definition value="The medical devices section contains narrative text and coded entries describing the patient history of medical device use." />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries, future releases may further constrain this section as more jurisdictions look to support its use" />
<max value="1" />
</element>
<element id="Composition.section:sectionMedicalDevices.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
</element>
<element id="Composition.section:sectionMedicalDevices.title">
<path value="Composition.section.title" />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionMedicalDevices.code">
<path value="Composition.section.code" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="46264-8" />
</coding>
</patternCodeableConcept>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionMedicalDevices.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Patient history of medical device use." />
<definition value="It describes the patient history of medical device use. This entry shall be used to document that no information about medical device use is available, or that no relevant medical device use is known." />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionMedicalDevices.entry:deviceStatement">
<path value="Composition.section.entry" />
<sliceName value="deviceStatement" />
<comment value="Pending definition of a PS CA device use section profile in a future release of PS CA, implementors are encouraged to use the IPS device use section profile." />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/uv/ips/StructureDefinition/DeviceUseStatement-uv-ips" />
</type>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionMedicalDevices.section">
<path value="Composition.section.section" />
<max value="0" />
</element>
<element id="Composition.section:sectionResults">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Results Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionResults" />
<short value="PS-CA Results Section" />
<definition value="This section assembles relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. Some of these results may be laboratory results, others may be anatomic pathology results, others, radiology results, and others, clinical results." />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content" />
<max value="1" />
</element>
<element id="Composition.section:sectionResults.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
</element>
<element id="Composition.section:sectionResults.title">
<path value="Composition.section.title" />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionResults.code">
<path value="Composition.section.code" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="30954-2" />
</coding>
</patternCodeableConcept>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionResults.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient." />
<definition value="Relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. Some of these results may be laboratory results, others may be anatomic pathology results, others, radiology results, and others, clinical results." />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionResults.entry:results-observation-laboratory-pathology">
<path value="Composition.section.entry" />
<sliceName value="results-observation-laboratory-pathology" />
<min value="0" />
<max value="*" />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-results-laboratory-pathology-ca-ps" />
</type>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionResults.entry:results-observation-radiology">
<path value="Composition.section.entry" />
<sliceName value="results-observation-radiology" />
<min value="0" />
<max value="*" />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-results-radiology-ca-ps" />
</type>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionResults.entry:results-diagnosticReport">
<path value="Composition.section.entry" />
<sliceName value="results-diagnosticReport" />
<comment value="Pending definition of a PS CA diagnostic report profile in a future release of PS CA, implementors are encouraged to use the IPS diagnostic report profile." />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/diagnosticreport-ca-ps" />
</type>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionResults.section">
<path value="Composition.section.section" />
<max value="0" />
</element>
<element id="Composition.section:sectionVitalSigns">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Vital Signs Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionVitalSigns" />
<label value="Vital signs" />
<short value="PS-CA Vital Signs Section" />
<definition value="The Vital signs section includes blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included" />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content" />
<max value="1" />
</element>
<element id="Composition.section:sectionVitalSigns.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
</element>
<element id="Composition.section:sectionVitalSigns.title">
<path value="Composition.section.title" />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionVitalSigns.code">
<path value="Composition.section.code" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="8716-3" />
</coding>
</patternCodeableConcept>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionVitalSigns.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Notable vital signs or physical findings." />
<definition value="Notable vital signs or physical findings as: blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included" />
<comment value="IPS-UV and PS-CA point to the parent vital signs profile (http://hl7.org/fhir/StructureDefinition/vitalsigns) in the base FHIR specification, it is up to the jurisdictions to select and support the individual vital sign profiles. However, to support implementers in validation - the individual vital signs profiles have been included as individual slices below. The parent vital signs profile has been removed as a slice to prevent examples from matching multiple slices." />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionVitalSigns.entry:BMI">
<path value="Composition.section.entry" />
<sliceName value="BMI" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/bmi" />
</type>
</element>
<element id="Composition.section:sectionVitalSigns.entry:BP">
<path value="Composition.section.entry" />
<sliceName value="BP" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/bp" />
</type>
</element>
<element id="Composition.section:sectionVitalSigns.entry:BodyHeight">
<path value="Composition.section.entry" />
<sliceName value="BodyHeight" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/bodyheight" />
</type>
</element>
<element id="Composition.section:sectionVitalSigns.entry:BodyTemp">
<path value="Composition.section.entry" />
<sliceName value="BodyTemp" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/bodytemp" />
</type>
</element>
<element id="Composition.section:sectionVitalSigns.entry:BodyWeight">
<path value="Composition.section.entry" />
<sliceName value="BodyWeight" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/bodyweight" />
</type>
</element>
<element id="Composition.section:sectionVitalSigns.entry:HeadCircum">
<path value="Composition.section.entry" />
<sliceName value="HeadCircum" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/headcircum" />
</type>
</element>
<element id="Composition.section:sectionVitalSigns.entry:HeartRate">
<path value="Composition.section.entry" />
<sliceName value="HeartRate" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/heartrate" />
</type>
</element>
<element id="Composition.section:sectionVitalSigns.entry:OxygenSat">
<path value="Composition.section.entry" />
<sliceName value="OxygenSat" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/oxygensat" />
</type>
</element>
<element id="Composition.section:sectionVitalSigns.entry:RespRate">
<path value="Composition.section.entry" />
<sliceName value="RespRate" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/resprate" />
</type>
</element>
<element id="Composition.section:sectionVitalSigns.entry:VitalsPanel">
<path value="Composition.section.entry" />
<sliceName value="VitalsPanel" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/vitalspanel" />
</type>
</element>
<element id="Composition.section:sectionVitalSigns.section">
<path value="Composition.section.section" />
<max value="0" />
</element>
<element id="Composition.section:sectionPastIllnessHx">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionPastIllnessHx" />
<short value="PS-CA History of Past Illness Section" />
<definition value="The History of Past Illness section contains a description of the conditions the patient suffered in the past." />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content" />
<max value="1" />
</element>
<element id="Composition.section:sectionPastIllnessHx.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
</element>
<element id="Composition.section:sectionPastIllnessHx.title">
<path value="Composition.section.title" />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionPastIllnessHx.code">
<path value="Composition.section.code" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="11348-0" />
</coding>
</patternCodeableConcept>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionPastIllnessHx.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Conditions the patient suffered in the past." />
<definition value="It contains a description of the conditions the patient suffered in the past." />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionPastIllnessHx.entry:pastProblem">
<path value="Composition.section.entry" />
<sliceName value="pastProblem" />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/condition-ca-ps" />
</type>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionPastIllnessHx.section">
<path value="Composition.section.section" />
<max value="0" />
</element>
<element id="Composition.section:sectionFunctionalStatus">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionFunctionalStatus" />
<short value="PS-CA Functional Status" />
<definition value="The functional status section shall contain a narrative description of capability of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments.\nProfiles to express disabilities and functional assessments will be specified by future versions of this guide." />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error." />
<max value="1" />
</element>
<element id="Composition.section:sectionFunctionalStatus.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
</element>
<element id="Composition.section:sectionFunctionalStatus.title">
<path value="Composition.section.title" />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionFunctionalStatus.code">
<path value="Composition.section.code" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="47420-5" />
</coding>
</patternCodeableConcept>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionFunctionalStatus.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Optional entry used to represent disabilities and functional assessments" />
<definition value="It describes capabilities of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments.\nProfiles to express disabilities and functional assessments will be specified by future versions of this guide." />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionFunctionalStatus.entry:disability">
<path value="Composition.section.entry" />
<sliceName value="disability" />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/condition-ca-ps" />
</type>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionFunctionalStatus.entry:functionalAssessment">
<path value="Composition.section.entry" />
<sliceName value="functionalAssessment" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ClinicalImpression" />
</type>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionFunctionalStatus.section">
<path value="Composition.section.section" />
<max value="0" />
</element>
<element id="Composition.section:sectionPlanOfCare">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionPlanOfCare" />
<short value="PS-CA Plan of Care Section" />
<definition value="The plan of care section contains a narrative description of the expectations for care including proposals, goals, and order requests for monitoring, tracking, or improving the condition of the patient." />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error." />
<max value="1" />
</element>
<element id="Composition.section:sectionPlanOfCare.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
</element>
<element id="Composition.section:sectionPlanOfCare.title">
<path value="Composition.section.title" />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionPlanOfCare.code">
<path value="Composition.section.code" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="18776-5" />
</coding>
</patternCodeableConcept>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionPlanOfCare.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Optional entry used to represent structured care plans" />
<definition value="Dynamic, personalized plan including identified needed healthcare activity, health objectives and healthcare goals, relating to one or more specified health issues in a healthcare process [Source EN ISO 13940]" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionPlanOfCare.entry:carePlan">
<path value="Composition.section.entry" />
<sliceName value="carePlan" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" />
</type>
</element>
<element id="Composition.section:sectionPlanOfCare.entry:documentReference">
<path value="Composition.section.entry" />
<sliceName value="documentReference" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference" />
</type>
</element>
<element id="Composition.section:sectionPlanOfCare.section">
<path value="Composition.section.section" />
<max value="0" />
</element>
<element id="Composition.section:sectionSocialHistory">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionSocialHistory" />
<short value="PS-CA Social History Section" />
<definition value="The social history section contains a description of the person’s Health related "lifestyle factors" or "lifestyle observations" (e.g., smoke habits; alcohol consumption; diets, risky habits.)" />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content" />
<max value="1" />
</element>
<element id="Composition.section:sectionSocialHistory.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
</element>
<element id="Composition.section:sectionSocialHistory.title">
<path value="Composition.section.title" />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionSocialHistory.code">
<path value="Composition.section.code" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="29762-2" />
</coding>
</patternCodeableConcept>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionSocialHistory.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Health related "lifestyle factors" or "lifestyle observations" (e.g., smoke habits; alcohol consumption; diets, risky habits.)" />
<definition value="Description of the person’s Health related “lifestyle factors" or "lifestyle observations" (e.g., smoke habits; alcohol consumption; diets, risky habits.)" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionSocialHistory.entry:generalSocialHistory">
<path value="Composition.section.entry" />
<sliceName value="generalSocialHistory" />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-socialhistory-ca-ps" />
</type>
</element>
<element id="Composition.section:sectionSocialHistory.entry:smokingTobaccoUse">
<path value="Composition.section.entry" />
<sliceName value="smokingTobaccoUse" />
<max value="1" />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-tobaccouse-ca-ps" />
</type>
</element>
<element id="Composition.section:sectionSocialHistory.entry:alcoholUse">
<path value="Composition.section.entry" />
<sliceName value="alcoholUse" />
<max value="1" />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-alcoholuse-ca-ps" />
</type>
</element>
<element id="Composition.section:sectionSocialHistory.section">
<path value="Composition.section.section" />
<max value="0" />
</element>
<element id="Composition.section:sectionPregnancyHx">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionPregnancyHx" />
<short value="PS-CA History of Pregnancy Section" />
<definition value="The history of pregnancy section shall contain information about whether the patient is currently pregnant or not.\nIt may contain addition summarizing information about the outcome of earlier pregnancies." />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error." />
<max value="1" />
</element>
<element id="Composition.section:sectionPregnancyHx.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
</element>
<element id="Composition.section:sectionPregnancyHx.title">
<path value="Composition.section.title" />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionPregnancyHx.code">
<path value="Composition.section.code" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="10162-6" />
</coding>
</patternCodeableConcept>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionPregnancyHx.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Current pregnancy status and, optionally, information about the outcome of earlier pregnancies." />
<definition value="It contains information about whether the patient is currently pregnant or not.\nIt may contain addition summarizing information about the outcome of earlier pregnancies." />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionPregnancyHx.entry:pregnancyStatus">
<path value="Composition.section.entry" />
<sliceName value="pregnancyStatus" />
<comment value="Pending definition of a PS CA pregnancy status observation profile in a future release of PS CA, implementors are encouraged to use the IPS pregnancy status observation profile." />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/uv/ips/StructureDefinition/Observation-pregnancy-status-uv-ips" />
</type>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionPregnancyHx.entry:pregnancyOutcomeSummary">
<path value="Composition.section.entry" />
<sliceName value="pregnancyOutcomeSummary" />
<comment value="Pending definition of a PS CA pregnancy outcome observation profile in a future release of PS CA, implementors are encouraged to use the IPS pregnancy outcome observation profile." />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/uv/ips/StructureDefinition/Observation-pregnancy-outcome-uv-ips" />
</type>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionPregnancyHx.section">
<path value="Composition.section.section" />
<max value="0" />
</element>
<element id="Composition.section:sectionAdvanceDirectives">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionAdvanceDirectives" />
<short value="PS-CA Advance Directives Section" />
<definition value="The advance directives section contains a narrative description of patient's advance directive." />
<comment value="IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries." />
<max value="1" />
</element>
<element id="Composition.section:sectionAdvanceDirectives.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
</element>
<element id="Composition.section:sectionAdvanceDirectives.title">
<path value="Composition.section.title" />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionAdvanceDirectives.code">
<path value="Composition.section.code" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="42348-3" />
</coding>
</patternCodeableConcept>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionAdvanceDirectives.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Narrative description of the patient's advance directive." />
<definition value="Contains a narrative description or a Consent entry with information about the patient's advance directive." />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent">
<path value="Composition.section.entry" />
<sliceName value="advanceDirectivesConsent" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Consent" />
</type>
</element>
<element id="Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesDocumentReference">
<path value="Composition.section.entry" />
<sliceName value="advanceDirectivesDocumentReference" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference" />
</type>
</element>
<element id="Composition.section:sectionAdvanceDirectives.section">
<path value="Composition.section.section" />
<max value="0" />
</element>
<element id="Composition.section:sectionFamilyHistory">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionFamilyHistory" />
<short value="PS-CA Family History Section" />
<definition value="The family history section contains a description of the patient's family history." />
<comment value="This is a new section being introduced by the PS-CA specification at the request of jurisdictions." />
<max value="1" />
</element>
<element id="Composition.section:sectionFamilyHistory.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
</element>
<element id="Composition.section:sectionFamilyHistory.title">
<path value="Composition.section.title" />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionFamilyHistory.code">
<path value="Composition.section.code" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="10157-6" />
</coding>
</patternCodeableConcept>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionFamilyHistory.entry">
<path value="Composition.section.entry" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Narrative description of the patient's family history." />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionFamilyHistory.entry:FamilyMemberHistory">
<path value="Composition.section.entry" />
<sliceName value="FamilyMemberHistory" />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/familymemberhistory-ca-ps" />
</type>
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionFamilyHistory.section">
<path value="Composition.section.section" />
<max value="0" />
</element>
<element id="Composition.section:sectionPatientStory">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Section" />
</extension>
<path value="Composition.section" />
<sliceName value="sectionPatientStory" />
<short value="PS-CA Patient Story Section" />
<definition value="The section contains narrative text along with optional resources that express what matters to a patient. This may include needs, strengths, values, concerns and preferences to others providing support and care. The patient’s story, provided here, may be told by the patient or by a proxy." />
<comment value="This is a new section being introduced by the PS-CA specification at the request of jurisdictions. While the Patient Story section is relatively unconstrained at this time, information that is better suited to another section should not be included in the Patient Story. For example, DNR orders should be placed in the Advanced Directives section." />
<min value="0" />
<max value="1" />
</element>
<element id="Composition.section:sectionPatientStory.extension:section-note">
<path value="Composition.section.extension" />
<sliceName value="section-note" />
<short value="Additional notes that apply to the section (but not to specific resource)." />
<definition value="Additional notes that apply to the section (but not to specific resource)." />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/note" />
</type>
</element>
<element id="Composition.section:sectionPatientStory.title">
<path value="Composition.section.title" />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Composition.section:sectionPatientStory.code">
<path value="Composition.section.code" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="81338-6" />
</coding>
</patternCodeableConcept>
<mustSupport value="true" />
</element>
</differential>
</StructureDefinition>
{
"resourceType": "StructureDefinition",
"id": "composition-ca-ps",
"url": "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps",
"name": "CompositionPSCA",
"title": "Composition (PS-CA)",
"status": "draft",
"experimental": false,
"date": "2023-12-21T00:00:00-08:00",
"description": "This profile represents the constraints applied to the Composition resource by the PS-CA project.\nA Canadian Patient Summary (PS-CA) document is an electronic health record extract containing essential healthcare information about a subject of care. It is informed by the IPS-UV Composition profile, but differs in its application of Must Support flags on some of the sections to allow for jurisdictional implementors flexibility in what sections systems Must Support in order to show conformance to their respective patient summaries.\nThe PS-CA dataset is minimal and non-exhaustive; specialty-agnostic and condition-independent; but still clinically relevant. It is informed by the requirements specified in EN 17269 and ISO/DIS 27269, it is designed for supporting the international use case scenario for ‘unplanned, cross border care’, but is also designed to support a variety of use cases for cross-jurisdiction exchange. It is intended to guide implementation nationally while ensuring international exchange of patient summaries is not impeded.\n\nThis profile is based on the ClinicalDocument profile from the base R4 FHIR standard.",
"copyright": "Copyright © 2024+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
"fhirVersion": "4.0.1",
"kind": "resource",
"abstract": false,
"type": "Composition",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Composition",
"derivation": "constraint",
"snapshot": {
"element": [
{
"id": "Composition",
"path": "Composition",
"short": "Canadian Patient Summary composition",
"definition": "Canadian Patient Summary composition.\nA composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement.\nWhile a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained.",
"comment": "While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.",
"min": 0,
"max": "*",
"base": {
"path": "Composition",
"min": 0,
"max": "*"
},
"constraint": [
{
"key": "dom-2",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"expression": "contained.contained.empty()",
"xpath": "not(parent::f:contained and f:contained)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-3",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
"expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-4",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-5",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a security label",
"expression": "contained.meta.security.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:security))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean": true
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
}
],
"key": "dom-6",
"severity": "warning",
"human": "A resource should have narrative for robust management",
"expression": "text.`div`.exists()",
"xpath": "exists(f:text/h:div)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
},
{
"identity": "workflow",
"map": "Event"
},
{
"identity": "rim",
"map": "Document[classCode=\"DOC\" and moodCode=\"EVN\" and isNormalAct()]"
},
{
"identity": "cda",
"map": "ClinicalDocument"
},
{
"identity": "fhirdocumentreference",
"map": "when described by DocumentReference"
}
]
},
{
"id": "Composition.id",
"path": "Composition.id",
"short": "Logical id of this artifact",
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": true
},
{
"id": "Composition.meta",
"path": "Composition.meta",
"short": "Metadata about the resource",
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.meta",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Meta"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true
},
{
"id": "Composition.implicitRules",
"path": "Composition.implicitRules",
"short": "A set of rules under which this content was created",
"definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
"comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.implicitRules",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
"isSummary": true
},
{
"id": "Composition.language",
"path": "Composition.language",
"short": "Language of the resource content",
"definition": "The base language in which the resource is written.",
"comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
"min": 0,
"max": "1",
"base": {
"path": "Resource.language",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
}
],
"strength": "preferred",
"description": "A human language.",
"valueSet": "http://hl7.org/fhir/ValueSet/languages"
}
},
{
"id": "Composition.text",
"path": "Composition.text",
"short": "Text summary of the resource, for human interpretation",
"definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"comment": "PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.",
"alias": [
"narrative",
"html",
"xhtml",
"display"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "Act.text?"
}
]
},
{
"id": "Composition.contained",
"path": "Composition.contained",
"short": "Contained, inline Resources",
"definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
"comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
"alias": [
"inline resources",
"anonymous resources",
"contained resources"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.contained",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Resource"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.extension",
"path": "Composition.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.modifierExtension",
"path": "Composition.modifierExtension",
"short": "Extensions that cannot be ignored",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.identifier",
"path": "Composition.identifier",
"short": "Version-independent identifier for the Composition",
"definition": "A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.",
"comment": "Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.identifier",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Identifier"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.identifier"
},
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "rim",
"map": "Document.id / Document.setId"
},
{
"identity": "cda",
"map": ".setId"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.masterIdentifier"
}
]
},
{
"id": "Composition.status",
"path": "Composition.status",
"short": "preliminary | final | amended | entered-in-error",
"definition": "The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.",
"comment": "If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag \"entered-in-error\" is why this element is labeled as a modifier of other elements. \n\nSome reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.",
"requirements": "Need to be able to mark interim, amended, or withdrawn compositions or documents.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.status",
"min": 1,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": true,
"isModifierReason": "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionStatus"
}
],
"strength": "required",
"description": "The workflow/clinical status of the composition.",
"valueSet": "http://hl7.org/fhir/ValueSet/composition-status|4.0.1"
},
"mapping": [
{
"identity": "workflow",
"map": "Event.status"
},
{
"identity": "w5",
"map": "FiveWs.status"
},
{
"identity": "rim",
"map": "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(\"ReviseComposition\", code) and isNormalAct()]); amended: .completionCode=\"AU\" && ./statusCode[isNormalDatatype()]=\"complete\" and ./inboundRelationship[typeCode=\"SUBJ\" and isNormalActRelationship()]/source[subsumesCode(\"ActClass#CACT\") and moodCode=\"EVN\" and domainMember(\"ReviseComposition\", code) and isNormalAct() and statusCode=\"completed\"]; withdrawn : .completionCode=NI && ./statusCode[isNormalDatatype()]=\"obsolete\""
},
{
"identity": "cda",
"map": "n/a"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.status"
}
]
},
{
"id": "Composition.type",
"path": "Composition.type",
"short": "Kind of composition (\"Patient Summary\")",
"definition": "Specifies that this composition refers to a Patient Summary (Loinc \"60591-5\")",
"comment": "For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.",
"requirements": "Key metadata element describing the composition, used in searching/filtering.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.type",
"min": 1,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "60591-5"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DocumentType"
}
],
"strength": "preferred",
"description": "Type of a composition.",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-typecodes"
},
"mapping": [
{
"identity": "workflow",
"map": "Event.code"
},
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": "./code"
},
{
"identity": "cda",
"map": ".code"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.type"
}
]
},
{
"id": "Composition.category",
"path": "Composition.category",
"short": "Categorization of Composition",
"definition": "A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.",
"comment": "This is a metadata field from [XDS/MHD](http://wiki.ihe.net/index.php?title=Mobile_access_to_Health_Documents_(MHD)).",
"requirements": "Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.category",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DocumentCategory"
}
],
"strength": "example",
"description": "High-level kind of a clinical document at a macro level.",
"valueSet": "http://hl7.org/fhir/ValueSet/document-classcodes"
},
"mapping": [
{
"identity": "workflow",
"map": "Event.subject"
},
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"EVN\"].code"
},
{
"identity": "cda",
"map": "n/a"
},
{
"identity": "fhirdocumentreference",
"map": "DocumenttReference.category"
}
]
},
{
"id": "Composition.subject",
"path": "Composition.subject",
"short": "Who and/or what the composition is about",
"definition": "Who or what the composition is about.\nIn general a composition 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 livestock, or a set of patients that share a common exposure).\nFor the PS the subject is always the patient.",
"comment": "For clinical documents, this is usually the patient.",
"requirements": "Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.subject",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.subject[x]"
},
{
"identity": "rim",
"map": ".participation[typeCode=\"SBJ\"].role[typeCode=\"PAT\"]"
},
{
"identity": "cda",
"map": ".recordTarget"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.subject"
},
{
"identity": "w5",
"map": "FiveWs.subject"
}
]
},
{
"id": "Composition.subject.id",
"path": "Composition.subject.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.subject.extension",
"path": "Composition.subject.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.subject.reference",
"path": "Composition.subject.reference",
"short": "Literal reference, Relative, internal or absolute URL",
"definition": "A 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.",
"comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
"min": 1,
"max": "1",
"base": {
"path": "Reference.reference",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ref-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.subject.type",
"path": "Composition.subject.type",
"short": "Type the reference refers to (e.g. \"Patient\")",
"definition": "The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. \"Patient\" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).",
"comment": "This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "FHIRResourceTypeExt"
}
],
"strength": "extensible",
"description": "Aa resource (or, for logical models, the URI of the logical model).",
"valueSet": "http://hl7.org/fhir/ValueSet/resource-types"
},
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.subject.identifier",
"path": "Composition.subject.identifier",
"short": "Logical reference, when literal reference is not known",
"definition": "An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
"comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen 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\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).",
"min": 0,
"max": "1",
"base": {
"path": "Reference.identifier",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Identifier"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": ".identifier"
}
]
},
{
"id": "Composition.subject.display",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "Composition.subject.display",
"short": "Text alternative for the resource",
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"comment": "This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.encounter",
"path": "Composition.encounter",
"short": "Context of the Composition",
"definition": "Describes the clinical encounter or type of care this documentation is associated with.",
"comment": "While IPS-UV considers this a Must Support element, policy has not yet been developed in Canada confirming the expectations for when a patient summary is created (e.g., does it have to be created by a health professional or just validated, can it be automatically assembled, does it have to occur within an encounter, etc.). This relaxation does not exclude or prevent implementers from further defining how encounter is used in their implementation if their use case(s) rely on its presence.",
"requirements": "Provides context for the composition and supports searching.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.encounter",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Encounter"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.context"
},
{
"identity": "w5",
"map": "FiveWs.context"
},
{
"identity": "rim",
"map": "unique(highest(./outboundRelationship[typeCode=\"SUBJ\" and isNormalActRelationship()], priorityNumber)/target[moodCode=\"EVN\" and classCode=(\"ENC\", \"PCPR\") and isNormalAct])"
},
{
"identity": "cda",
"map": ".componentOf.encompassingEncounter"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.context.encounter"
}
]
},
{
"id": "Composition.date",
"path": "Composition.date",
"short": "Composition editing time",
"definition": "The composition editing time, when the composition was last logically changed by the author.",
"comment": "The Last Modified Date on the composition may be after the date of the document was attested without being changed.",
"requirements": "dateTime is used for tracking, organizing versions and searching. Note that this is the time of *authoring*. When packaged in a document, [Bundle.timestamp](bundle-definitions.html#Bundle.timestamp) is the date of packaging.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.date",
"min": 1,
"max": "1"
},
"type": [
{
"code": "dateTime"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.occurrence[x]"
},
{
"identity": "w5",
"map": "FiveWs.done[x]"
},
{
"identity": "rim",
"map": ".effectiveTime[type=\"TS\"]"
},
{
"identity": "cda",
"map": ".effectiveTime"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.content.attachment.date, DocumentReference.created"
}
]
},
{
"id": "Composition.author",
"path": "Composition.author",
"short": "Who and/or what authored the patient summary",
"definition": "Identifies who is responsible for the information in the patient summary, not necessarily who typed it in.\n\nThe type of author(s) contribute to determine the \"nature\"of the Patient Summary: e.g., a \"human-curated\" PS Vs. an \"automatically generated\" PS.",
"requirements": "Identifies who is responsible for the content.",
"min": 1,
"max": "*",
"base": {
"path": "Composition.author",
"min": 1,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner",
"http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.performer"
},
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "rim",
"map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]"
},
{
"identity": "cda",
"map": ".author.assignedAuthor"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.agent"
}
]
},
{
"id": "Composition.title",
"path": "Composition.title",
"short": "CA Patient Summary",
"definition": "Official human-readable label for the composition.\n\nFor this document should be \"CA Patient Summary\" or any equivalent translation",
"comment": "For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a \"consultation\" or \"progress note\"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.title",
"min": 1,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "./title"
},
{
"identity": "cda",
"map": ".title"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.description, DocumentReference.content.attachment.title"
}
]
},
{
"id": "Composition.confidentiality",
"path": "Composition.confidentiality",
"short": "As defined by affinity domain",
"definition": "The code specifying the level of confidentiality of the Composition.",
"comment": "The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.confidentiality",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DocumentConfidentiality"
}
],
"strength": "required",
"description": "Codes specifying the level of confidentiality of the composition.",
"valueSet": "http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26"
},
"mapping": [
{
"identity": "rim",
"map": ".confidentialityCode"
},
{
"identity": "cda",
"map": ".confidentialityCode"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.securityLabel"
}
]
},
{
"id": "Composition.attester",
"path": "Composition.attester",
"short": "Attests to accuracy of composition",
"definition": "A participant who has attested to the accuracy of the composition/document.",
"comment": "IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported across workflows of Canadian jurisdictional implementers. \n\n These challenges have been raised in IPS. Further assessment of jurisdictional use cases need to be explored by the Patient Summary Working Group before the constraint will be re-considered for inclusion",
"requirements": "Identifies responsibility for the accuracy of the composition content.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.attester",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".participation[typeCode=\"AUTHEN\"].role[classCode=\"ASSIGNED\"]"
},
{
"identity": "cda",
"map": ".authenticator/.legalAuthenticator"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.authenticator"
}
]
},
{
"id": "Composition.attester.id",
"path": "Composition.attester.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.attester.extension",
"path": "Composition.attester.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.attester.modifierExtension",
"path": "Composition.attester.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.attester.mode",
"path": "Composition.attester.mode",
"short": "personal | professional | legal | official",
"definition": "The type of attestation the authenticator offers.",
"comment": "While Composition.attester is not currently flagged as Must Support in PS-CA, Implementers who support attester are expected to support attester.mode, attester.time, and attester.party",
"requirements": "Indicates the level of authority of the attestation.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.attester.mode",
"min": 1,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionAttestationMode"
}
],
"strength": "required",
"description": "The way in which a person authenticated a composition.",
"valueSet": "http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "unique(./modeCode)"
},
{
"identity": "cda",
"map": "implied by .authenticator/.legalAuthenticator"
}
]
},
{
"id": "Composition.attester.time",
"path": "Composition.attester.time",
"short": "When the composition was attested",
"definition": "When the composition was attested by the party.",
"comment": "While Composition.attester is not currently flagged as Must Support in PS-CA, Implementers who support attester are expected to support attester.mode, attester.time, and attester.party",
"requirements": "Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).",
"min": 0,
"max": "1",
"base": {
"path": "Composition.attester.time",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./time[type=\"TS\" and isNormalDatatype()]"
},
{
"identity": "cda",
"map": ".authenticator.time"
}
]
},
{
"id": "Composition.attester.party",
"path": "Composition.attester.party",
"short": "Who attested the composition",
"definition": "Who attested the composition in the specified way.",
"comment": "While Composition.attester is not currently flagged as Must Support in PS-CA, Implementers who support attester are expected to support attester.mode, attester.time, and attester.party",
"requirements": "Identifies who has taken on the responsibility for accuracy of the composition content.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.attester.party",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner",
"http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole",
"http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.witness"
},
{
"identity": "rim",
"map": "./role[classCode=\"ASSIGNED\" and isNormalRole]/player[determinerCode=\"INST\" and classCode=(\"DEV\", \"PSN\") and isNormalEntity()] or ./role[classCode=\"ASSIGNED\" and isNormalRole and not(player)]/scoper[determinerCode=\"INST\" and classCode=\"ORG\" and isNormalEntity()]"
},
{
"identity": "cda",
"map": ".authenticator.assignedEnttty"
}
]
},
{
"id": "Composition.custodian",
"path": "Composition.custodian",
"short": "Organization which maintains the composition",
"definition": "Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.",
"comment": "This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.",
"requirements": "Identifies where to go to find the current version, where to report issues, etc.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.custodian",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": ".participation[typeCode=\"RCV\"].role[classCode=\"CUST\"].scoper[classCode=\"ORG\" and determinerCode=\"INST\"]"
},
{
"identity": "cda",
"map": ".custodian.assignedCustodian"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.custodian"
}
]
},
{
"id": "Composition.relatesTo",
"path": "Composition.relatesTo",
"short": "Relationships to other compositions/documents",
"definition": "Relationships that this composition has with other compositions or documents that already exist.",
"comment": "A document is a version specific composition.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.relatesTo",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship"
},
{
"identity": "cda",
"map": ".relatedDocument"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.relatesTo"
}
]
},
{
"id": "Composition.relatesTo.id",
"path": "Composition.relatesTo.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.relatesTo.extension",
"path": "Composition.relatesTo.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.relatesTo.modifierExtension",
"path": "Composition.relatesTo.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.relatesTo.code",
"path": "Composition.relatesTo.code",
"short": "replaces | transforms | signs | appends",
"definition": "The type of relationship that this composition has with anther composition or document.",
"comment": "If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.relatesTo.code",
"min": 1,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DocumentRelationshipType"
}
],
"strength": "required",
"description": "The type of relationship between documents.",
"valueSet": "http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship.typeCode"
},
{
"identity": "cda",
"map": ".relatedDocument.typeCode"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.relatesTo.code"
}
]
},
{
"id": "Composition.relatesTo.target[x]",
"path": "Composition.relatesTo.target[x]",
"short": "Target of the relationship",
"definition": "The target composition/document of this relationship.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.relatesTo.target[x]",
"min": 1,
"max": "1"
},
"type": [
{
"code": "Identifier"
},
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Composition",
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".target[classCode=\"DOC\", moodCode=\"EVN\"].id"
},
{
"identity": "cda",
"map": ".relatedDocument.id"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.relatesTo.target"
}
]
},
{
"id": "Composition.event",
"path": "Composition.event",
"slicing": {
"discriminator": [
{
"type": "pattern",
"path": "code"
}
],
"rules": "open"
},
"short": "The clinical service(s) being documented",
"definition": "IPS Note: The main activity being described by a PS is the provision of healthcare over a period of time. In the CDA representation of the PS this is shown by setting the value of serviceEvent/@classCode to “PCPR” (care provision) and indicating the duration over which care was provided in serviceEvent/effectiveTime. In the FHIR representation at least one event should be used to record this information. Additional data from outside this duration may also be included if it is relevant to care provided during that time range (e.g., reviewed during the stated time range). For example if the PS is generated by a GP based on information recorded in his/her EHR-S, then the start value should represent the date when the treatment relationship between the patient and the GP started; and the end value the date of the latest care event.",
"comment": "The event needs to be consistent with the type element, though can provide further information if desired.",
"requirements": "Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.event",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "outboundRelationship[typeCode=\"SUBJ\"].target[classCode<'ACT']"
},
{
"identity": "cda",
"map": ".documentationOf.serviceEvent"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.event"
}
]
},
{
"id": "Composition.event.id",
"path": "Composition.event.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.event.extension",
"path": "Composition.event.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.event.modifierExtension",
"path": "Composition.event.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.event.code",
"path": "Composition.event.code",
"short": "Code(s) that apply to the event being documented",
"definition": "This 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.",
"comment": "An event can further specialize the act inherent in the typeCode, such as where it is simply \"Procedure Report\" and the procedure was a \"colonoscopy\". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.event.code",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DocumentEventType"
}
],
"strength": "example",
"description": "This list of codes represents the main clinical acts being documented.",
"valueSet": "http://terminology.hl7.org/ValueSet/v3-ActCode"
},
"mapping": [
{
"identity": "rim",
"map": ".code"
},
{
"identity": "cda",
"map": ".code"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.event.code"
}
]
},
{
"id": "Composition.event.period",
"path": "Composition.event.period",
"short": "The period covered by the documentation",
"definition": "The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.event.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": ".effectiveTime"
},
{
"identity": "cda",
"map": ".effectiveTime"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.event.period"
}
]
},
{
"id": "Composition.event.detail",
"path": "Composition.event.detail",
"short": "The event(s) being documented",
"definition": "The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.event.detail",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=\"SUBJ\"].target"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.event:careProvisioningEvent",
"path": "Composition.event",
"sliceName": "careProvisioningEvent",
"short": "The care provisioning being documented",
"definition": "The provision of healthcare over a period of time this PS is documented.",
"comment": "The event needs to be consistent with the type element, though can provide further information if desired.",
"requirements": "Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.event",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "outboundRelationship[typeCode=\"SUBJ\"].target[classCode<'ACT']"
},
{
"identity": "cda",
"map": ".documentationOf.serviceEvent"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.event"
}
]
},
{
"id": "Composition.event:careProvisioningEvent.id",
"path": "Composition.event.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.event:careProvisioningEvent.extension",
"path": "Composition.event.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.event:careProvisioningEvent.modifierExtension",
"path": "Composition.event.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.event:careProvisioningEvent.code",
"path": "Composition.event.code",
"short": "Code(s) that apply to the event being documented",
"definition": "This 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.",
"comment": "While Composition.event:careProvisioningEvent slice is not currently flagged as Must Support in PS-CA, Implementers who support the slice are expected to support Composition.event:careProvisioningEvent.code and Composition.event:careProvisioningEvent.period",
"min": 1,
"max": "*",
"base": {
"path": "Composition.event.code",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActClass",
"code": "PCPR"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DocumentEventType"
}
],
"strength": "example",
"description": "This list of codes represents the main clinical acts being documented.",
"valueSet": "http://terminology.hl7.org/ValueSet/v3-ActCode"
},
"mapping": [
{
"identity": "rim",
"map": ".code"
},
{
"identity": "cda",
"map": ".code"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.event.code"
}
]
},
{
"id": "Composition.event:careProvisioningEvent.period",
"path": "Composition.event.period",
"short": "The period covered by the documentation",
"definition": "The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.",
"comment": "While Composition.event:careProvisioningEvent slice is not currently flagged as Must Support in PS-CA, Implementers who support the slice are expected to support Composition.event:careProvisioningEvent.code and Composition.event:careProvisioningEvent.period",
"min": 0,
"max": "1",
"base": {
"path": "Composition.event.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": ".effectiveTime"
},
{
"identity": "cda",
"map": ".effectiveTime"
},
{
"identity": "fhirdocumentreference",
"map": "DocumentReference.event.period"
}
]
},
{
"id": "Composition.event:careProvisioningEvent.detail",
"path": "Composition.event.detail",
"short": "The event(s) being documented",
"definition": "The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.event.detail",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=\"SUBJ\"].target"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"slicing": {
"discriminator": [
{
"type": "pattern",
"path": "code"
}
],
"ordered": false,
"rules": "open"
},
"short": "Sections composing the PS",
"definition": "The root of the sections that make up the PS-CA composition.",
"min": 1,
"max": "*",
"base": {
"path": "Composition.section",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "cmp-1",
"severity": "error",
"human": "A section must contain at least one of text, entries, or sub-sections",
"expression": "text.exists() or entry.exists() or section.exists()",
"xpath": "exists(f:text) or exists(f:entry) or exists(f:section)"
},
{
"key": "cmp-2",
"severity": "error",
"human": "A section can only have an emptyReason if it is empty",
"expression": "emptyReason.empty() or entry.empty()",
"xpath": "not(exists(f:emptyReason) and exists(f:entry))"
},
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.structuredBody.component.section"
}
]
},
{
"id": "Composition.section.id",
"path": "Composition.section.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section.extension",
"path": "Composition.section.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section.modifierExtension",
"path": "Composition.section.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.section.title",
"path": "Composition.section.title",
"short": "Label for section (e.g. for ToC)",
"definition": "The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.",
"comment": "The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.",
"requirements": "Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.",
"alias": [
"header",
"label",
"caption"
],
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.title",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./title"
},
{
"identity": "cda",
"map": ".title"
}
]
},
{
"id": "Composition.section.code",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
}
],
"path": "Composition.section.code",
"short": "Concept - reference to a terminology or just text",
"definition": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
"comment": "For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text.",
"requirements": "Provides computable standardized labels to topics within the document.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept",
"profile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionSectionType"
}
],
"strength": "example",
"description": "Classification of a section of a composition/document.",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes"
},
"mapping": [
{
"identity": "rim",
"map": "./code"
},
{
"identity": "cda",
"map": ".code"
},
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
}
]
},
{
"id": "Composition.section.author",
"path": "Composition.section.author",
"short": "Who and/or what authored the section",
"definition": "Identifies who is responsible for the information in this section, not necessarily who typed it in.",
"requirements": "Identifies who is responsible for the content.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.author",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "rim",
"map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]"
},
{
"identity": "cda",
"map": ".author.assignedAuthor"
}
]
},
{
"id": "Composition.section.focus",
"path": "Composition.section.focus",
"short": "Who/what the section is about, when it is not about the subject of composition",
"definition": "The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).",
"comment": "Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.focus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "cda",
"map": ".subject? (CDA did not differentiate between subject and focus)"
}
]
},
{
"id": "Composition.section.text",
"path": "Composition.section.text",
"short": "Text summary of the section, for human interpretation",
"definition": "A human-readable narrative that contains the attested content of the section, 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.",
"comment": "PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".text"
},
{
"identity": "cda",
"map": ".text"
}
]
},
{
"id": "Composition.section.mode",
"path": "Composition.section.mode",
"short": "working | snapshot | changes",
"definition": "How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.",
"comment": "This element is labeled as a modifier because a change list must not be misunderstood as a complete list.",
"requirements": "Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.mode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionMode"
}
],
"strength": "required",
"description": "The processing mode that applies to this section.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-mode|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section.orderedBy",
"path": "Composition.section.orderedBy",
"short": "Order of section entries",
"definition": "Specifies the order applied to the items in the section entries.",
"comment": "Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.",
"requirements": "Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.orderedBy",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEntryOrder"
}
],
"strength": "preferred",
"description": "What order applies to the items in the entry.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-order"
},
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section.entry",
"path": "Composition.section.entry",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section.emptyReason",
"path": "Composition.section.emptyReason",
"short": "Why the section is empty",
"definition": "If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.",
"comment": "The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.",
"requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEmptyReason"
}
],
"strength": "preferred",
"description": "If a section is empty, why it is empty.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-empty-reason"
},
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section.section",
"path": "Composition.section.section",
"short": "Nested Section",
"definition": "A nested sub-section within this section.",
"comment": "Nested sections are primarily used to help human readers navigate to particular portions of the document.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.section",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Composition#Composition.section",
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.section"
}
]
},
{
"id": "Composition.section:sectionMedications",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionMedications",
"short": "PS-CA Medication Summary Section",
"definition": "The medication summary section contains a description of the patient's medications relevant for the scope of the patient summary. The actual content could depend on the jurisdiction, it could report:\n- the currently active medications;\n- the current and past medications considered relevant by the authoring GP;\n- the patient prescriptions or dispensations automatically extracted by a regional or a national EHR.\n\nBecause This section has been expanded in the PS-CA to model a medicationRequest profile in addition to medicationStatement profile initially included in IPS-UV.",
"comment": "IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of data - though has recently updated to allow for the provision of section.emptyReason. This constraint has been maintained in the PS-CA. Systems should utilize the section.entry with a resource when conveying that the subject has no known medications (e.g., clinical assertions that are captured alongside supportive data like date). The section.emptyReason is available to convey details for why the section entry is empty (e.g., data unavailable).",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "cmp-1",
"severity": "error",
"human": "A section must contain at least one of text, entries, or sub-sections",
"expression": "text.exists() or entry.exists() or section.exists()",
"xpath": "exists(f:text) or exists(f:entry) or exists(f:section)",
"source": "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps"
},
{
"key": "cmp-2",
"severity": "error",
"human": "A section can only have an emptyReason if it is empty",
"expression": "emptyReason.empty() or entry.empty()",
"xpath": "not(exists(f:emptyReason) and exists(f:entry))",
"source": "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps"
},
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ips-comp-1",
"severity": "error",
"human": "Either section.entry or emptyReason are present",
"expression": "(entry.reference.exists() or emptyReason.exists())",
"xpath": "(/f:entry.reference and not /f:emptyReason) or (not(/f:emptyReason) and /f:entry.reference)",
"source": "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.structuredBody.component.section"
}
]
},
{
"id": "Composition.section:sectionMedications.id",
"path": "Composition.section.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionMedications.extension",
"path": "Composition.section.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionMedications.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionMedications.modifierExtension",
"path": "Composition.section.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.section:sectionMedications.title",
"path": "Composition.section.title",
"short": "Medication Summary section",
"definition": "The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.\n\nMedication Summary",
"comment": "The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.",
"requirements": "Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.",
"alias": [
"header",
"label",
"caption"
],
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.title",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./title"
},
{
"identity": "cda",
"map": ".title"
}
]
},
{
"id": "Composition.section:sectionMedications.code",
"path": "Composition.section.code",
"short": "Classification of section (recommended)",
"definition": "A code identifying the kind of content contained within the section. This must be consistent with the section title.",
"comment": "The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.",
"requirements": "Provides computable standardized labels to topics within the document.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "10160-0"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionSectionType"
}
],
"strength": "example",
"description": "Classification of a section of a composition/document.",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes"
},
"mapping": [
{
"identity": "rim",
"map": "./code"
},
{
"identity": "cda",
"map": ".code"
}
]
},
{
"id": "Composition.section:sectionMedications.author",
"path": "Composition.section.author",
"short": "Who and/or what authored the section",
"definition": "Identifies who is responsible for the information in this section, not necessarily who typed it in.",
"requirements": "Identifies who is responsible for the content.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.author",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "rim",
"map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]"
},
{
"identity": "cda",
"map": ".author.assignedAuthor"
}
]
},
{
"id": "Composition.section:sectionMedications.focus",
"path": "Composition.section.focus",
"short": "Who/what the section is about, when it is not about the subject of composition",
"definition": "The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).",
"comment": "Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.focus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "cda",
"map": ".subject? (CDA did not differentiate between subject and focus)"
}
]
},
{
"id": "Composition.section:sectionMedications.text",
"path": "Composition.section.text",
"short": "Text summary of the section, for human interpretation",
"definition": "A human-readable narrative that contains the attested content of the section, 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.",
"comment": "Document profiles may define what content should be represented in the narrative to ensure clinical safety.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".text"
},
{
"identity": "cda",
"map": ".text"
}
]
},
{
"id": "Composition.section:sectionMedications.mode",
"path": "Composition.section.mode",
"short": "working | snapshot | changes",
"definition": "How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.",
"comment": "This element is labeled as a modifier because a change list must not be misunderstood as a complete list.",
"requirements": "Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.mode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionMode"
}
],
"strength": "required",
"description": "The processing mode that applies to this section.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-mode|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionMedications.orderedBy",
"path": "Composition.section.orderedBy",
"short": "Order of section entries",
"definition": "Specifies the order applied to the items in the section entries.",
"comment": "Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.",
"requirements": "Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.orderedBy",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEntryOrder"
}
],
"strength": "preferred",
"description": "What order applies to the items in the entry.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-order"
},
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionMedications.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Medications relevant for the scope of the patient summary",
"definition": "This list the medications relevant for the scope of the patient summary or it is used to indicate that the subject is known not to be on any relevant medication",
"comment": "This entry requires a medicationStatement or a medicationRequest.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionMedications.entry:medicationStatement",
"path": "Composition.section.entry",
"sliceName": "medicationStatement",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/medicationstatement-ca-ps"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionMedications.entry:medicationRequest",
"path": "Composition.section.entry",
"sliceName": "medicationRequest",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/medicationrequest-ca-ps"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionMedications.emptyReason",
"path": "Composition.section.emptyReason",
"short": "Why the section is empty",
"definition": "If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.",
"comment": "The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.",
"requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEmptyReason"
}
],
"strength": "preferred",
"description": "If a section is empty, why it is empty.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-empty-reason"
},
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionMedications.section",
"path": "Composition.section.section",
"short": "Nested Section",
"definition": "A nested sub-section within this section.",
"comment": "Nested sections are primarily used to help human readers navigate to particular portions of the document.",
"min": 0,
"max": "0",
"base": {
"path": "Composition.section.section",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Composition#Composition.section",
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.section"
}
]
},
{
"id": "Composition.section:sectionAllergies",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionAllergies",
"short": "PS-CA Allergies and Intolerances Section",
"definition": "This section documents the relevant allergies or intolerances (conditions) for that patient, describing the kind of reaction (e.g., rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy.\nAt a minimum, it should list currently active and any relevant historical allergies and adverse reactions.\nIf no information about allergies is available, or if no allergies are known this should be clearly documented in the section.",
"comment": "IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of data - though has recently updated to allow for the provision of section.emptyReason. This constraint has been maintained in the PS-CA. Systems should utilize the section.entry with a resource when conveying that the subject has no known allergies (e.g., clinical assertions that are captured alongside supportive data like date). The section.emptyReason is available to convey details for why the section entry is empty (e.g., data unavailable).",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "cmp-1",
"severity": "error",
"human": "A section must contain at least one of text, entries, or sub-sections",
"expression": "text.exists() or entry.exists() or section.exists()",
"xpath": "exists(f:text) or exists(f:entry) or exists(f:section)",
"source": "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps"
},
{
"key": "cmp-2",
"severity": "error",
"human": "A section can only have an emptyReason if it is empty",
"expression": "emptyReason.empty() or entry.empty()",
"xpath": "not(exists(f:emptyReason) and exists(f:entry))",
"source": "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps"
},
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ips-comp-1",
"severity": "error",
"human": "Either section.entry or emptyReason are present",
"expression": "(entry.reference.exists() or emptyReason.exists())",
"xpath": "(/f:entry.reference and not /f:emptyReason) or (not(/f:emptyReason) and /f:entry.reference)",
"source": "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.structuredBody.component.section"
}
]
},
{
"id": "Composition.section:sectionAllergies.id",
"path": "Composition.section.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionAllergies.extension",
"path": "Composition.section.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionAllergies.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionAllergies.modifierExtension",
"path": "Composition.section.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.section:sectionAllergies.title",
"path": "Composition.section.title",
"short": "Allergies and Intolerances",
"definition": "The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.",
"comment": "The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.",
"requirements": "Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.",
"alias": [
"header",
"label",
"caption"
],
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.title",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./title"
},
{
"identity": "cda",
"map": ".title"
}
]
},
{
"id": "Composition.section:sectionAllergies.code",
"path": "Composition.section.code",
"short": "Classification of section (recommended)",
"definition": "A code identifying the kind of content contained within the section. This must be consistent with the section title.",
"comment": "The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.",
"requirements": "Provides computable standardized labels to topics within the document.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "48765-2"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionSectionType"
}
],
"strength": "example",
"description": "Classification of a section of a composition/document.",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes"
},
"mapping": [
{
"identity": "rim",
"map": "./code"
},
{
"identity": "cda",
"map": ".code"
}
]
},
{
"id": "Composition.section:sectionAllergies.author",
"path": "Composition.section.author",
"short": "Who and/or what authored the section",
"definition": "Identifies who is responsible for the information in this section, not necessarily who typed it in.",
"requirements": "Identifies who is responsible for the content.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.author",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "rim",
"map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]"
},
{
"identity": "cda",
"map": ".author.assignedAuthor"
}
]
},
{
"id": "Composition.section:sectionAllergies.focus",
"path": "Composition.section.focus",
"short": "Who/what the section is about, when it is not about the subject of composition",
"definition": "The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).",
"comment": "Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.focus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "cda",
"map": ".subject? (CDA did not differentiate between subject and focus)"
}
]
},
{
"id": "Composition.section:sectionAllergies.text",
"path": "Composition.section.text",
"short": "Text summary of the section, for human interpretation",
"definition": "A human-readable narrative that contains the attested content of the section, 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.",
"comment": "Document profiles may define what content should be represented in the narrative to ensure clinical safety.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".text"
},
{
"identity": "cda",
"map": ".text"
}
]
},
{
"id": "Composition.section:sectionAllergies.mode",
"path": "Composition.section.mode",
"short": "working | snapshot | changes",
"definition": "How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.",
"comment": "This element is labeled as a modifier because a change list must not be misunderstood as a complete list.",
"requirements": "Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.mode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionMode"
}
],
"strength": "required",
"description": "The processing mode that applies to this section.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-mode|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionAllergies.orderedBy",
"path": "Composition.section.orderedBy",
"short": "Order of section entries",
"definition": "Specifies the order applied to the items in the section entries.",
"comment": "Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.",
"requirements": "Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.orderedBy",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEntryOrder"
}
],
"strength": "preferred",
"description": "What order applies to the items in the entry.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-order"
},
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionAllergies.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Relevant allergies or intolerances (conditions) for that patient.",
"definition": "It lists the relevant allergies or intolerances (conditions) for that patient, describing the kind of reaction (e.g., rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy.\nAt a minimum, it should list currently active and any relevant historical allergies and adverse reactions.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionAllergies.entry:allergyOrIntolerance",
"path": "Composition.section.entry",
"sliceName": "allergyOrIntolerance",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/allergyintolerance-ca-ps"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionAllergies.emptyReason",
"path": "Composition.section.emptyReason",
"short": "Why the section is empty",
"definition": "If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.",
"comment": "The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.",
"requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEmptyReason"
}
],
"strength": "preferred",
"description": "If a section is empty, why it is empty.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-empty-reason"
},
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionAllergies.section",
"path": "Composition.section.section",
"short": "Nested Section",
"definition": "A nested sub-section within this section.",
"comment": "Nested sections are primarily used to help human readers navigate to particular portions of the document.",
"min": 0,
"max": "0",
"base": {
"path": "Composition.section.section",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Composition#Composition.section",
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.section"
}
]
},
{
"id": "Composition.section:sectionProblems",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionProblems",
"short": "PS-CA Problems Section",
"definition": "The PS problem section lists and describes clinical problems or conditions currently being monitored for the patient.",
"comment": "IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of data - though has recently updated to allow for the provision of section.emptyReason. This constraint has been maintained in the PS-CA. Systems should utilize the section.entry with a resource when conveying that the subject has no known conditions (e.g., clinical assertions that are captured alongside supportive data like date). The section.emptyReason is available to convey details for why the section entry is empty (e.g., data unavailable).",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "cmp-1",
"severity": "error",
"human": "A section must contain at least one of text, entries, or sub-sections",
"expression": "text.exists() or entry.exists() or section.exists()",
"xpath": "exists(f:text) or exists(f:entry) or exists(f:section)",
"source": "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps"
},
{
"key": "cmp-2",
"severity": "error",
"human": "A section can only have an emptyReason if it is empty",
"expression": "emptyReason.empty() or entry.empty()",
"xpath": "not(exists(f:emptyReason) and exists(f:entry))",
"source": "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps"
},
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ips-comp-1",
"severity": "error",
"human": "Either section.entry or emptyReason are present",
"expression": "(entry.reference.exists() or emptyReason.exists())",
"xpath": "(/f:entry.reference and not /f:emptyReason) or (not(/f:emptyReason) and /f:entry.reference)",
"source": "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.structuredBody.component.section"
}
]
},
{
"id": "Composition.section:sectionProblems.id",
"path": "Composition.section.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionProblems.extension",
"path": "Composition.section.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionProblems.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionProblems.modifierExtension",
"path": "Composition.section.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.section:sectionProblems.title",
"path": "Composition.section.title",
"short": "Label for section (e.g. for ToC)",
"definition": "The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.",
"comment": "The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.",
"requirements": "Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.",
"alias": [
"header",
"label",
"caption"
],
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.title",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./title"
},
{
"identity": "cda",
"map": ".title"
}
]
},
{
"id": "Composition.section:sectionProblems.code",
"path": "Composition.section.code",
"short": "Classification of section (recommended)",
"definition": "A code identifying the kind of content contained within the section. This must be consistent with the section title.",
"comment": "The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.",
"requirements": "Provides computable standardized labels to topics within the document.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "11450-4"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionSectionType"
}
],
"strength": "example",
"description": "Classification of a section of a composition/document.",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes"
},
"mapping": [
{
"identity": "rim",
"map": "./code"
},
{
"identity": "cda",
"map": ".code"
}
]
},
{
"id": "Composition.section:sectionProblems.author",
"path": "Composition.section.author",
"short": "Who and/or what authored the section",
"definition": "Identifies who is responsible for the information in this section, not necessarily who typed it in.",
"requirements": "Identifies who is responsible for the content.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.author",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "rim",
"map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]"
},
{
"identity": "cda",
"map": ".author.assignedAuthor"
}
]
},
{
"id": "Composition.section:sectionProblems.focus",
"path": "Composition.section.focus",
"short": "Who/what the section is about, when it is not about the subject of composition",
"definition": "The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).",
"comment": "Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.focus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "cda",
"map": ".subject? (CDA did not differentiate between subject and focus)"
}
]
},
{
"id": "Composition.section:sectionProblems.text",
"path": "Composition.section.text",
"short": "Text summary of the section, for human interpretation",
"definition": "A human-readable narrative that contains the attested content of the section, 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.",
"comment": "Document profiles may define what content should be represented in the narrative to ensure clinical safety.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".text"
},
{
"identity": "cda",
"map": ".text"
}
]
},
{
"id": "Composition.section:sectionProblems.mode",
"path": "Composition.section.mode",
"short": "working | snapshot | changes",
"definition": "How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.",
"comment": "This element is labeled as a modifier because a change list must not be misunderstood as a complete list.",
"requirements": "Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.mode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionMode"
}
],
"strength": "required",
"description": "The processing mode that applies to this section.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-mode|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionProblems.orderedBy",
"path": "Composition.section.orderedBy",
"short": "Order of section entries",
"definition": "Specifies the order applied to the items in the section entries.",
"comment": "Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.",
"requirements": "Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.orderedBy",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEntryOrder"
}
],
"strength": "preferred",
"description": "What order applies to the items in the entry.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-order"
},
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionProblems.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Clinical problems or conditions currently being monitored for the patient.",
"definition": "It lists and describes clinical problems or conditions currently being monitored for the patient.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionProblems.entry:problem",
"path": "Composition.section.entry",
"sliceName": "problem",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/condition-ca-ps"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionProblems.emptyReason",
"path": "Composition.section.emptyReason",
"short": "Why the section is empty",
"definition": "If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.",
"comment": "The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.",
"requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEmptyReason"
}
],
"strength": "preferred",
"description": "If a section is empty, why it is empty.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-empty-reason"
},
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionProblems.section",
"path": "Composition.section.section",
"short": "Nested Section",
"definition": "A nested sub-section within this section.",
"comment": "Nested sections are primarily used to help human readers navigate to particular portions of the document.",
"min": 0,
"max": "0",
"base": {
"path": "Composition.section.section",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Composition#Composition.section",
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.section"
}
]
},
{
"id": "Composition.section:sectionProceduresHx",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionProceduresHx",
"short": "PS-CA History of Procedures Section",
"definition": "The History of Procedures Section contains a description of the patient past procedures that are pertinent to the scope of this document.\nProcedures may refer for example to:\n1. Invasive Diagnostic procedure: e.g., Cardiac catheterization; (the results of these procedure are documented in the results section)\n2. Therapeutic procedure: e.g., dialysis;\n3. Surgical procedure: e.g., appendectomy",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "cmp-1",
"severity": "error",
"human": "A section must contain at least one of text, entries, or sub-sections",
"expression": "text.exists() or entry.exists() or section.exists()",
"xpath": "exists(f:text) or exists(f:entry) or exists(f:section)"
},
{
"key": "cmp-2",
"severity": "error",
"human": "A section can only have an emptyReason if it is empty",
"expression": "emptyReason.empty() or entry.empty()",
"xpath": "not(exists(f:emptyReason) and exists(f:entry))"
},
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.structuredBody.component.section"
}
]
},
{
"id": "Composition.section:sectionProceduresHx.id",
"path": "Composition.section.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionProceduresHx.extension",
"path": "Composition.section.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionProceduresHx.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionProceduresHx.modifierExtension",
"path": "Composition.section.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.section:sectionProceduresHx.title",
"path": "Composition.section.title",
"short": "Label for section (e.g. for ToC)",
"definition": "The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.",
"comment": "The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.",
"requirements": "Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.",
"alias": [
"header",
"label",
"caption"
],
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.title",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./title"
},
{
"identity": "cda",
"map": ".title"
}
]
},
{
"id": "Composition.section:sectionProceduresHx.code",
"path": "Composition.section.code",
"short": "Classification of section (recommended)",
"definition": "A code identifying the kind of content contained within the section. This must be consistent with the section title.",
"comment": "The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.",
"requirements": "Provides computable standardized labels to topics within the document.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "47519-4"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionSectionType"
}
],
"strength": "example",
"description": "Classification of a section of a composition/document.",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes"
},
"mapping": [
{
"identity": "rim",
"map": "./code"
},
{
"identity": "cda",
"map": ".code"
}
]
},
{
"id": "Composition.section:sectionProceduresHx.author",
"path": "Composition.section.author",
"short": "Who and/or what authored the section",
"definition": "Identifies who is responsible for the information in this section, not necessarily who typed it in.",
"requirements": "Identifies who is responsible for the content.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.author",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "rim",
"map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]"
},
{
"identity": "cda",
"map": ".author.assignedAuthor"
}
]
},
{
"id": "Composition.section:sectionProceduresHx.focus",
"path": "Composition.section.focus",
"short": "Who/what the section is about, when it is not about the subject of composition",
"definition": "The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).",
"comment": "Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.focus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "cda",
"map": ".subject? (CDA did not differentiate between subject and focus)"
}
]
},
{
"id": "Composition.section:sectionProceduresHx.text",
"path": "Composition.section.text",
"short": "Text summary of the section, for human interpretation",
"definition": "A human-readable narrative that contains the attested content of the section, 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.",
"comment": "Document profiles may define what content should be represented in the narrative to ensure clinical safety.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".text"
},
{
"identity": "cda",
"map": ".text"
}
]
},
{
"id": "Composition.section:sectionProceduresHx.mode",
"path": "Composition.section.mode",
"short": "working | snapshot | changes",
"definition": "How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.",
"comment": "This element is labeled as a modifier because a change list must not be misunderstood as a complete list.",
"requirements": "Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.mode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionMode"
}
],
"strength": "required",
"description": "The processing mode that applies to this section.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-mode|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionProceduresHx.orderedBy",
"path": "Composition.section.orderedBy",
"short": "Order of section entries",
"definition": "Specifies the order applied to the items in the section entries.",
"comment": "Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.",
"requirements": "Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.orderedBy",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEntryOrder"
}
],
"strength": "preferred",
"description": "What order applies to the items in the entry.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-order"
},
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionProceduresHx.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Patient past procedures pertinent to the scope of this document.",
"definition": "It lists the patient past procedures that are pertinent to the scope of this document.\nProcedures may refer for example to:\n1. Invasive Diagnostic procedure: e.g., Cardiac catheterization; (the results of these procedure are documented in the results section)\n2. Therapeutic procedure: e.g., dialysis;\n3. Surgical procedure: e.g., appendectomy.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionProceduresHx.entry:procedure",
"path": "Composition.section.entry",
"sliceName": "procedure",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/procedure-ca-ps"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionProceduresHx.emptyReason",
"path": "Composition.section.emptyReason",
"short": "Why the section is empty",
"definition": "If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.",
"comment": "The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.",
"requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEmptyReason"
}
],
"strength": "preferred",
"description": "If a section is empty, why it is empty.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-empty-reason"
},
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionProceduresHx.section",
"path": "Composition.section.section",
"short": "Nested Section",
"definition": "A nested sub-section within this section.",
"comment": "Nested sections are primarily used to help human readers navigate to particular portions of the document.",
"min": 0,
"max": "0",
"base": {
"path": "Composition.section.section",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Composition#Composition.section",
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.section"
}
]
},
{
"id": "Composition.section:sectionImmunizations",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionImmunizations",
"short": "PS-CA Immunizations Section",
"definition": "The Immunizations Section defines a patient's current immunization status and pertinent immunization history.\nThe primary use case for the Immunization Section is to enable communication of a patient's immunization status.\nThe section includes the current immunization status, and may contain the entire immunization history that is relevant to the period of time being summarized.",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "cmp-1",
"severity": "error",
"human": "A section must contain at least one of text, entries, or sub-sections",
"expression": "text.exists() or entry.exists() or section.exists()",
"xpath": "exists(f:text) or exists(f:entry) or exists(f:section)"
},
{
"key": "cmp-2",
"severity": "error",
"human": "A section can only have an emptyReason if it is empty",
"expression": "emptyReason.empty() or entry.empty()",
"xpath": "not(exists(f:emptyReason) and exists(f:entry))"
},
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.structuredBody.component.section"
}
]
},
{
"id": "Composition.section:sectionImmunizations.id",
"path": "Composition.section.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionImmunizations.extension",
"path": "Composition.section.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionImmunizations.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionImmunizations.modifierExtension",
"path": "Composition.section.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.section:sectionImmunizations.title",
"path": "Composition.section.title",
"short": "Label for section (e.g. for ToC)",
"definition": "The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.",
"comment": "The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.",
"requirements": "Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.",
"alias": [
"header",
"label",
"caption"
],
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.title",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./title"
},
{
"identity": "cda",
"map": ".title"
}
]
},
{
"id": "Composition.section:sectionImmunizations.code",
"path": "Composition.section.code",
"short": "Classification of section (recommended)",
"definition": "A code identifying the kind of content contained within the section. This must be consistent with the section title.",
"comment": "The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.",
"requirements": "Provides computable standardized labels to topics within the document.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "11369-6"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionSectionType"
}
],
"strength": "example",
"description": "Classification of a section of a composition/document.",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes"
},
"mapping": [
{
"identity": "rim",
"map": "./code"
},
{
"identity": "cda",
"map": ".code"
}
]
},
{
"id": "Composition.section:sectionImmunizations.author",
"path": "Composition.section.author",
"short": "Who and/or what authored the section",
"definition": "Identifies who is responsible for the information in this section, not necessarily who typed it in.",
"requirements": "Identifies who is responsible for the content.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.author",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "rim",
"map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]"
},
{
"identity": "cda",
"map": ".author.assignedAuthor"
}
]
},
{
"id": "Composition.section:sectionImmunizations.focus",
"path": "Composition.section.focus",
"short": "Who/what the section is about, when it is not about the subject of composition",
"definition": "The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).",
"comment": "Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.focus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "cda",
"map": ".subject? (CDA did not differentiate between subject and focus)"
}
]
},
{
"id": "Composition.section:sectionImmunizations.text",
"path": "Composition.section.text",
"short": "Text summary of the section, for human interpretation",
"definition": "A human-readable narrative that contains the attested content of the section, 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.",
"comment": "Document profiles may define what content should be represented in the narrative to ensure clinical safety.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".text"
},
{
"identity": "cda",
"map": ".text"
}
]
},
{
"id": "Composition.section:sectionImmunizations.mode",
"path": "Composition.section.mode",
"short": "working | snapshot | changes",
"definition": "How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.",
"comment": "This element is labeled as a modifier because a change list must not be misunderstood as a complete list.",
"requirements": "Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.mode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionMode"
}
],
"strength": "required",
"description": "The processing mode that applies to this section.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-mode|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionImmunizations.orderedBy",
"path": "Composition.section.orderedBy",
"short": "Order of section entries",
"definition": "Specifies the order applied to the items in the section entries.",
"comment": "Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.",
"requirements": "Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.orderedBy",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEntryOrder"
}
],
"strength": "preferred",
"description": "What order applies to the items in the entry.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-order"
},
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionImmunizations.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Patient's immunization status and pertinent history.",
"definition": "It defines the patient's current immunization status and pertinent immunization history.\nThe primary use case for the Immunization Section is to enable communication of a patient's immunization status.\nIt may contain the entire immunization history that is relevant to the period of time being summarized.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionImmunizations.entry:immunization",
"path": "Composition.section.entry",
"sliceName": "immunization",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/immunization-ca-ps"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionImmunizations.emptyReason",
"path": "Composition.section.emptyReason",
"short": "Why the section is empty",
"definition": "If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.",
"comment": "The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.",
"requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEmptyReason"
}
],
"strength": "preferred",
"description": "If a section is empty, why it is empty.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-empty-reason"
},
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionImmunizations.section",
"path": "Composition.section.section",
"short": "Nested Section",
"definition": "A nested sub-section within this section.",
"comment": "Nested sections are primarily used to help human readers navigate to particular portions of the document.",
"min": 0,
"max": "0",
"base": {
"path": "Composition.section.section",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Composition#Composition.section",
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.section"
}
]
},
{
"id": "Composition.section:sectionMedicalDevices",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionMedicalDevices",
"short": "PS-CA Medical Devices Section",
"definition": "The medical devices section contains narrative text and coded entries describing the patient history of medical device use.",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries, future releases may further constrain this section as more jurisdictions look to support its use",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "cmp-1",
"severity": "error",
"human": "A section must contain at least one of text, entries, or sub-sections",
"expression": "text.exists() or entry.exists() or section.exists()",
"xpath": "exists(f:text) or exists(f:entry) or exists(f:section)"
},
{
"key": "cmp-2",
"severity": "error",
"human": "A section can only have an emptyReason if it is empty",
"expression": "emptyReason.empty() or entry.empty()",
"xpath": "not(exists(f:emptyReason) and exists(f:entry))"
},
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.structuredBody.component.section"
}
]
},
{
"id": "Composition.section:sectionMedicalDevices.id",
"path": "Composition.section.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionMedicalDevices.extension",
"path": "Composition.section.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionMedicalDevices.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionMedicalDevices.modifierExtension",
"path": "Composition.section.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.section:sectionMedicalDevices.title",
"path": "Composition.section.title",
"short": "Label for section (e.g. for ToC)",
"definition": "The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.",
"comment": "The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.",
"requirements": "Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.",
"alias": [
"header",
"label",
"caption"
],
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.title",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./title"
},
{
"identity": "cda",
"map": ".title"
}
]
},
{
"id": "Composition.section:sectionMedicalDevices.code",
"path": "Composition.section.code",
"short": "Classification of section (recommended)",
"definition": "A code identifying the kind of content contained within the section. This must be consistent with the section title.",
"comment": "The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.",
"requirements": "Provides computable standardized labels to topics within the document.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "46264-8"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionSectionType"
}
],
"strength": "example",
"description": "Classification of a section of a composition/document.",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes"
},
"mapping": [
{
"identity": "rim",
"map": "./code"
},
{
"identity": "cda",
"map": ".code"
}
]
},
{
"id": "Composition.section:sectionMedicalDevices.author",
"path": "Composition.section.author",
"short": "Who and/or what authored the section",
"definition": "Identifies who is responsible for the information in this section, not necessarily who typed it in.",
"requirements": "Identifies who is responsible for the content.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.author",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "rim",
"map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]"
},
{
"identity": "cda",
"map": ".author.assignedAuthor"
}
]
},
{
"id": "Composition.section:sectionMedicalDevices.focus",
"path": "Composition.section.focus",
"short": "Who/what the section is about, when it is not about the subject of composition",
"definition": "The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).",
"comment": "Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.focus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "cda",
"map": ".subject? (CDA did not differentiate between subject and focus)"
}
]
},
{
"id": "Composition.section:sectionMedicalDevices.text",
"path": "Composition.section.text",
"short": "Text summary of the section, for human interpretation",
"definition": "A human-readable narrative that contains the attested content of the section, 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.",
"comment": "Document profiles may define what content should be represented in the narrative to ensure clinical safety.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".text"
},
{
"identity": "cda",
"map": ".text"
}
]
},
{
"id": "Composition.section:sectionMedicalDevices.mode",
"path": "Composition.section.mode",
"short": "working | snapshot | changes",
"definition": "How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.",
"comment": "This element is labeled as a modifier because a change list must not be misunderstood as a complete list.",
"requirements": "Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.mode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionMode"
}
],
"strength": "required",
"description": "The processing mode that applies to this section.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-mode|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionMedicalDevices.orderedBy",
"path": "Composition.section.orderedBy",
"short": "Order of section entries",
"definition": "Specifies the order applied to the items in the section entries.",
"comment": "Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.",
"requirements": "Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.orderedBy",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEntryOrder"
}
],
"strength": "preferred",
"description": "What order applies to the items in the entry.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-order"
},
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionMedicalDevices.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Patient history of medical device use.",
"definition": "It describes the patient history of medical device use. This entry shall be used to document that no information about medical device use is available, or that no relevant medical device use is known.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionMedicalDevices.entry:deviceStatement",
"path": "Composition.section.entry",
"sliceName": "deviceStatement",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "Pending definition of a PS CA device use section profile in a future release of PS CA, implementors are encouraged to use the IPS device use section profile.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/uv/ips/StructureDefinition/DeviceUseStatement-uv-ips"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionMedicalDevices.emptyReason",
"path": "Composition.section.emptyReason",
"short": "Why the section is empty",
"definition": "If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.",
"comment": "The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.",
"requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEmptyReason"
}
],
"strength": "preferred",
"description": "If a section is empty, why it is empty.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-empty-reason"
},
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionMedicalDevices.section",
"path": "Composition.section.section",
"short": "Nested Section",
"definition": "A nested sub-section within this section.",
"comment": "Nested sections are primarily used to help human readers navigate to particular portions of the document.",
"min": 0,
"max": "0",
"base": {
"path": "Composition.section.section",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Composition#Composition.section",
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.section"
}
]
},
{
"id": "Composition.section:sectionResults",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Results Section"
}
],
"path": "Composition.section",
"sliceName": "sectionResults",
"short": "PS-CA Results Section",
"definition": "This section assembles relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. Some of these results may be laboratory results, others may be anatomic pathology results, others, radiology results, and others, clinical results.",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "cmp-1",
"severity": "error",
"human": "A section must contain at least one of text, entries, or sub-sections",
"expression": "text.exists() or entry.exists() or section.exists()",
"xpath": "exists(f:text) or exists(f:entry) or exists(f:section)"
},
{
"key": "cmp-2",
"severity": "error",
"human": "A section can only have an emptyReason if it is empty",
"expression": "emptyReason.empty() or entry.empty()",
"xpath": "not(exists(f:emptyReason) and exists(f:entry))"
},
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.structuredBody.component.section"
}
]
},
{
"id": "Composition.section:sectionResults.id",
"path": "Composition.section.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionResults.extension",
"path": "Composition.section.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionResults.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionResults.modifierExtension",
"path": "Composition.section.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.section:sectionResults.title",
"path": "Composition.section.title",
"short": "Label for section (e.g. for ToC)",
"definition": "The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.",
"comment": "The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.",
"requirements": "Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.",
"alias": [
"header",
"label",
"caption"
],
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.title",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./title"
},
{
"identity": "cda",
"map": ".title"
}
]
},
{
"id": "Composition.section:sectionResults.code",
"path": "Composition.section.code",
"short": "Classification of section (recommended)",
"definition": "A code identifying the kind of content contained within the section. This must be consistent with the section title.",
"comment": "The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.",
"requirements": "Provides computable standardized labels to topics within the document.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "30954-2"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionSectionType"
}
],
"strength": "example",
"description": "Classification of a section of a composition/document.",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes"
},
"mapping": [
{
"identity": "rim",
"map": "./code"
},
{
"identity": "cda",
"map": ".code"
}
]
},
{
"id": "Composition.section:sectionResults.author",
"path": "Composition.section.author",
"short": "Who and/or what authored the section",
"definition": "Identifies who is responsible for the information in this section, not necessarily who typed it in.",
"requirements": "Identifies who is responsible for the content.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.author",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "rim",
"map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]"
},
{
"identity": "cda",
"map": ".author.assignedAuthor"
}
]
},
{
"id": "Composition.section:sectionResults.focus",
"path": "Composition.section.focus",
"short": "Who/what the section is about, when it is not about the subject of composition",
"definition": "The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).",
"comment": "Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.focus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "cda",
"map": ".subject? (CDA did not differentiate between subject and focus)"
}
]
},
{
"id": "Composition.section:sectionResults.text",
"path": "Composition.section.text",
"short": "Text summary of the section, for human interpretation",
"definition": "A human-readable narrative that contains the attested content of the section, 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.",
"comment": "Document profiles may define what content should be represented in the narrative to ensure clinical safety.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".text"
},
{
"identity": "cda",
"map": ".text"
}
]
},
{
"id": "Composition.section:sectionResults.mode",
"path": "Composition.section.mode",
"short": "working | snapshot | changes",
"definition": "How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.",
"comment": "This element is labeled as a modifier because a change list must not be misunderstood as a complete list.",
"requirements": "Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.mode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionMode"
}
],
"strength": "required",
"description": "The processing mode that applies to this section.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-mode|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionResults.orderedBy",
"path": "Composition.section.orderedBy",
"short": "Order of section entries",
"definition": "Specifies the order applied to the items in the section entries.",
"comment": "Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.",
"requirements": "Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.orderedBy",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEntryOrder"
}
],
"strength": "preferred",
"description": "What order applies to the items in the entry.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-order"
},
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionResults.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient.",
"definition": "Relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. Some of these results may be laboratory results, others may be anatomic pathology results, others, radiology results, and others, clinical results.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionResults.entry:results-observation-laboratory-pathology",
"path": "Composition.section.entry",
"sliceName": "results-observation-laboratory-pathology",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-results-laboratory-pathology-ca-ps"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionResults.entry:results-observation-radiology",
"path": "Composition.section.entry",
"sliceName": "results-observation-radiology",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-results-radiology-ca-ps"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionResults.entry:results-diagnosticReport",
"path": "Composition.section.entry",
"sliceName": "results-diagnosticReport",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "Pending definition of a PS CA diagnostic report profile in a future release of PS CA, implementors are encouraged to use the IPS diagnostic report profile.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/diagnosticreport-ca-ps"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionResults.emptyReason",
"path": "Composition.section.emptyReason",
"short": "Why the section is empty",
"definition": "If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.",
"comment": "The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.",
"requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEmptyReason"
}
],
"strength": "preferred",
"description": "If a section is empty, why it is empty.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-empty-reason"
},
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionResults.section",
"path": "Composition.section.section",
"short": "Nested Section",
"definition": "A nested sub-section within this section.",
"comment": "Nested sections are primarily used to help human readers navigate to particular portions of the document.",
"min": 0,
"max": "0",
"base": {
"path": "Composition.section.section",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Composition#Composition.section",
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.section"
}
]
},
{
"id": "Composition.section:sectionVitalSigns",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Vital Signs Section"
}
],
"path": "Composition.section",
"sliceName": "sectionVitalSigns",
"label": "Vital signs",
"short": "PS-CA Vital Signs Section",
"definition": "The Vital signs section includes blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "cmp-1",
"severity": "error",
"human": "A section must contain at least one of text, entries, or sub-sections",
"expression": "text.exists() or entry.exists() or section.exists()",
"xpath": "exists(f:text) or exists(f:entry) or exists(f:section)"
},
{
"key": "cmp-2",
"severity": "error",
"human": "A section can only have an emptyReason if it is empty",
"expression": "emptyReason.empty() or entry.empty()",
"xpath": "not(exists(f:emptyReason) and exists(f:entry))"
},
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.structuredBody.component.section"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.id",
"path": "Composition.section.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.extension",
"path": "Composition.section.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.modifierExtension",
"path": "Composition.section.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.title",
"path": "Composition.section.title",
"short": "Label for section (e.g. for ToC)",
"definition": "The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.",
"comment": "The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.",
"requirements": "Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.",
"alias": [
"header",
"label",
"caption"
],
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.title",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./title"
},
{
"identity": "cda",
"map": ".title"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.code",
"path": "Composition.section.code",
"short": "Classification of section (recommended)",
"definition": "A code identifying the kind of content contained within the section. This must be consistent with the section title.",
"comment": "The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.",
"requirements": "Provides computable standardized labels to topics within the document.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "8716-3"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionSectionType"
}
],
"strength": "example",
"description": "Classification of a section of a composition/document.",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes"
},
"mapping": [
{
"identity": "rim",
"map": "./code"
},
{
"identity": "cda",
"map": ".code"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.author",
"path": "Composition.section.author",
"short": "Who and/or what authored the section",
"definition": "Identifies who is responsible for the information in this section, not necessarily who typed it in.",
"requirements": "Identifies who is responsible for the content.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.author",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "rim",
"map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]"
},
{
"identity": "cda",
"map": ".author.assignedAuthor"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.focus",
"path": "Composition.section.focus",
"short": "Who/what the section is about, when it is not about the subject of composition",
"definition": "The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).",
"comment": "Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.focus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "cda",
"map": ".subject? (CDA did not differentiate between subject and focus)"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.text",
"path": "Composition.section.text",
"short": "Text summary of the section, for human interpretation",
"definition": "A human-readable narrative that contains the attested content of the section, 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.",
"comment": "Document profiles may define what content should be represented in the narrative to ensure clinical safety.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".text"
},
{
"identity": "cda",
"map": ".text"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.mode",
"path": "Composition.section.mode",
"short": "working | snapshot | changes",
"definition": "How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.",
"comment": "This element is labeled as a modifier because a change list must not be misunderstood as a complete list.",
"requirements": "Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.mode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionMode"
}
],
"strength": "required",
"description": "The processing mode that applies to this section.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-mode|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.orderedBy",
"path": "Composition.section.orderedBy",
"short": "Order of section entries",
"definition": "Specifies the order applied to the items in the section entries.",
"comment": "Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.",
"requirements": "Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.orderedBy",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEntryOrder"
}
],
"strength": "preferred",
"description": "What order applies to the items in the entry.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-order"
},
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Notable vital signs or physical findings.",
"definition": "Notable vital signs or physical findings as: blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included",
"comment": "IPS-UV and PS-CA point to the parent vital signs profile (http://hl7.org/fhir/StructureDefinition/vitalsigns) in the base FHIR specification, it is up to the jurisdictions to select and support the individual vital sign profiles. However, to support implementers in validation - the individual vital signs profiles have been included as individual slices below. The parent vital signs profile has been removed as a slice to prevent examples from matching multiple slices.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry:BMI",
"path": "Composition.section.entry",
"sliceName": "BMI",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/bmi"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry:BP",
"path": "Composition.section.entry",
"sliceName": "BP",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/bp"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry:BodyHeight",
"path": "Composition.section.entry",
"sliceName": "BodyHeight",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/bodyheight"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry:BodyTemp",
"path": "Composition.section.entry",
"sliceName": "BodyTemp",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/bodytemp"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry:BodyWeight",
"path": "Composition.section.entry",
"sliceName": "BodyWeight",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/bodyweight"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry:HeadCircum",
"path": "Composition.section.entry",
"sliceName": "HeadCircum",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/headcircum"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry:HeartRate",
"path": "Composition.section.entry",
"sliceName": "HeartRate",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/heartrate"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry:OxygenSat",
"path": "Composition.section.entry",
"sliceName": "OxygenSat",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/oxygensat"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry:RespRate",
"path": "Composition.section.entry",
"sliceName": "RespRate",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/resprate"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry:VitalsPanel",
"path": "Composition.section.entry",
"sliceName": "VitalsPanel",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/vitalspanel"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.emptyReason",
"path": "Composition.section.emptyReason",
"short": "Why the section is empty",
"definition": "If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.",
"comment": "The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.",
"requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEmptyReason"
}
],
"strength": "preferred",
"description": "If a section is empty, why it is empty.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-empty-reason"
},
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionVitalSigns.section",
"path": "Composition.section.section",
"short": "Nested Section",
"definition": "A nested sub-section within this section.",
"comment": "Nested sections are primarily used to help human readers navigate to particular portions of the document.",
"min": 0,
"max": "0",
"base": {
"path": "Composition.section.section",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Composition#Composition.section",
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.section"
}
]
},
{
"id": "Composition.section:sectionPastIllnessHx",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionPastIllnessHx",
"short": "PS-CA History of Past Illness Section",
"definition": "The History of Past Illness section contains a description of the conditions the patient suffered in the past.",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "cmp-1",
"severity": "error",
"human": "A section must contain at least one of text, entries, or sub-sections",
"expression": "text.exists() or entry.exists() or section.exists()",
"xpath": "exists(f:text) or exists(f:entry) or exists(f:section)"
},
{
"key": "cmp-2",
"severity": "error",
"human": "A section can only have an emptyReason if it is empty",
"expression": "emptyReason.empty() or entry.empty()",
"xpath": "not(exists(f:emptyReason) and exists(f:entry))"
},
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.structuredBody.component.section"
}
]
},
{
"id": "Composition.section:sectionPastIllnessHx.id",
"path": "Composition.section.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPastIllnessHx.extension",
"path": "Composition.section.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPastIllnessHx.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPastIllnessHx.modifierExtension",
"path": "Composition.section.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.section:sectionPastIllnessHx.title",
"path": "Composition.section.title",
"short": "Label for section (e.g. for ToC)",
"definition": "The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.",
"comment": "The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.",
"requirements": "Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.",
"alias": [
"header",
"label",
"caption"
],
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.title",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./title"
},
{
"identity": "cda",
"map": ".title"
}
]
},
{
"id": "Composition.section:sectionPastIllnessHx.code",
"path": "Composition.section.code",
"short": "Classification of section (recommended)",
"definition": "A code identifying the kind of content contained within the section. This must be consistent with the section title.",
"comment": "The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.",
"requirements": "Provides computable standardized labels to topics within the document.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "11348-0"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionSectionType"
}
],
"strength": "example",
"description": "Classification of a section of a composition/document.",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes"
},
"mapping": [
{
"identity": "rim",
"map": "./code"
},
{
"identity": "cda",
"map": ".code"
}
]
},
{
"id": "Composition.section:sectionPastIllnessHx.author",
"path": "Composition.section.author",
"short": "Who and/or what authored the section",
"definition": "Identifies who is responsible for the information in this section, not necessarily who typed it in.",
"requirements": "Identifies who is responsible for the content.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.author",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "rim",
"map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]"
},
{
"identity": "cda",
"map": ".author.assignedAuthor"
}
]
},
{
"id": "Composition.section:sectionPastIllnessHx.focus",
"path": "Composition.section.focus",
"short": "Who/what the section is about, when it is not about the subject of composition",
"definition": "The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).",
"comment": "Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.focus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "cda",
"map": ".subject? (CDA did not differentiate between subject and focus)"
}
]
},
{
"id": "Composition.section:sectionPastIllnessHx.text",
"path": "Composition.section.text",
"short": "Text summary of the section, for human interpretation",
"definition": "A human-readable narrative that contains the attested content of the section, 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.",
"comment": "Document profiles may define what content should be represented in the narrative to ensure clinical safety.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".text"
},
{
"identity": "cda",
"map": ".text"
}
]
},
{
"id": "Composition.section:sectionPastIllnessHx.mode",
"path": "Composition.section.mode",
"short": "working | snapshot | changes",
"definition": "How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.",
"comment": "This element is labeled as a modifier because a change list must not be misunderstood as a complete list.",
"requirements": "Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.mode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionMode"
}
],
"strength": "required",
"description": "The processing mode that applies to this section.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-mode|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPastIllnessHx.orderedBy",
"path": "Composition.section.orderedBy",
"short": "Order of section entries",
"definition": "Specifies the order applied to the items in the section entries.",
"comment": "Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.",
"requirements": "Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.orderedBy",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEntryOrder"
}
],
"strength": "preferred",
"description": "What order applies to the items in the entry.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-order"
},
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPastIllnessHx.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Conditions the patient suffered in the past.",
"definition": "It contains a description of the conditions the patient suffered in the past.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionPastIllnessHx.entry:pastProblem",
"path": "Composition.section.entry",
"sliceName": "pastProblem",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/condition-ca-ps"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionPastIllnessHx.emptyReason",
"path": "Composition.section.emptyReason",
"short": "Why the section is empty",
"definition": "If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.",
"comment": "The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.",
"requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEmptyReason"
}
],
"strength": "preferred",
"description": "If a section is empty, why it is empty.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-empty-reason"
},
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPastIllnessHx.section",
"path": "Composition.section.section",
"short": "Nested Section",
"definition": "A nested sub-section within this section.",
"comment": "Nested sections are primarily used to help human readers navigate to particular portions of the document.",
"min": 0,
"max": "0",
"base": {
"path": "Composition.section.section",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Composition#Composition.section",
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.section"
}
]
},
{
"id": "Composition.section:sectionFunctionalStatus",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionFunctionalStatus",
"short": "PS-CA Functional Status",
"definition": "The functional status section shall contain a narrative description of capability of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments.\nProfiles to express disabilities and functional assessments will be specified by future versions of this guide.",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "cmp-1",
"severity": "error",
"human": "A section must contain at least one of text, entries, or sub-sections",
"expression": "text.exists() or entry.exists() or section.exists()",
"xpath": "exists(f:text) or exists(f:entry) or exists(f:section)"
},
{
"key": "cmp-2",
"severity": "error",
"human": "A section can only have an emptyReason if it is empty",
"expression": "emptyReason.empty() or entry.empty()",
"xpath": "not(exists(f:emptyReason) and exists(f:entry))"
},
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.structuredBody.component.section"
}
]
},
{
"id": "Composition.section:sectionFunctionalStatus.id",
"path": "Composition.section.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionFunctionalStatus.extension",
"path": "Composition.section.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionFunctionalStatus.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionFunctionalStatus.modifierExtension",
"path": "Composition.section.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.section:sectionFunctionalStatus.title",
"path": "Composition.section.title",
"short": "Label for section (e.g. for ToC)",
"definition": "The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.",
"comment": "The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.",
"requirements": "Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.",
"alias": [
"header",
"label",
"caption"
],
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.title",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./title"
},
{
"identity": "cda",
"map": ".title"
}
]
},
{
"id": "Composition.section:sectionFunctionalStatus.code",
"path": "Composition.section.code",
"short": "Classification of section (recommended)",
"definition": "A code identifying the kind of content contained within the section. This must be consistent with the section title.",
"comment": "The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.",
"requirements": "Provides computable standardized labels to topics within the document.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "47420-5"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionSectionType"
}
],
"strength": "example",
"description": "Classification of a section of a composition/document.",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes"
},
"mapping": [
{
"identity": "rim",
"map": "./code"
},
{
"identity": "cda",
"map": ".code"
}
]
},
{
"id": "Composition.section:sectionFunctionalStatus.author",
"path": "Composition.section.author",
"short": "Who and/or what authored the section",
"definition": "Identifies who is responsible for the information in this section, not necessarily who typed it in.",
"requirements": "Identifies who is responsible for the content.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.author",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "rim",
"map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]"
},
{
"identity": "cda",
"map": ".author.assignedAuthor"
}
]
},
{
"id": "Composition.section:sectionFunctionalStatus.focus",
"path": "Composition.section.focus",
"short": "Who/what the section is about, when it is not about the subject of composition",
"definition": "The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).",
"comment": "Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.focus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "cda",
"map": ".subject? (CDA did not differentiate between subject and focus)"
}
]
},
{
"id": "Composition.section:sectionFunctionalStatus.text",
"path": "Composition.section.text",
"short": "Text summary of the section, for human interpretation",
"definition": "A human-readable narrative that contains the attested content of the section, 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.",
"comment": "Document profiles may define what content should be represented in the narrative to ensure clinical safety.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".text"
},
{
"identity": "cda",
"map": ".text"
}
]
},
{
"id": "Composition.section:sectionFunctionalStatus.mode",
"path": "Composition.section.mode",
"short": "working | snapshot | changes",
"definition": "How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.",
"comment": "This element is labeled as a modifier because a change list must not be misunderstood as a complete list.",
"requirements": "Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.mode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionMode"
}
],
"strength": "required",
"description": "The processing mode that applies to this section.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-mode|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionFunctionalStatus.orderedBy",
"path": "Composition.section.orderedBy",
"short": "Order of section entries",
"definition": "Specifies the order applied to the items in the section entries.",
"comment": "Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.",
"requirements": "Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.orderedBy",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEntryOrder"
}
],
"strength": "preferred",
"description": "What order applies to the items in the entry.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-order"
},
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionFunctionalStatus.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Optional entry used to represent disabilities and functional assessments",
"definition": "It describes capabilities of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments.\nProfiles to express disabilities and functional assessments will be specified by future versions of this guide.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionFunctionalStatus.entry:disability",
"path": "Composition.section.entry",
"sliceName": "disability",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/condition-ca-ps"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionFunctionalStatus.entry:functionalAssessment",
"path": "Composition.section.entry",
"sliceName": "functionalAssessment",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/ClinicalImpression"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionFunctionalStatus.emptyReason",
"path": "Composition.section.emptyReason",
"short": "Why the section is empty",
"definition": "If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.",
"comment": "The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.",
"requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEmptyReason"
}
],
"strength": "preferred",
"description": "If a section is empty, why it is empty.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-empty-reason"
},
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionFunctionalStatus.section",
"path": "Composition.section.section",
"short": "Nested Section",
"definition": "A nested sub-section within this section.",
"comment": "Nested sections are primarily used to help human readers navigate to particular portions of the document.",
"min": 0,
"max": "0",
"base": {
"path": "Composition.section.section",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Composition#Composition.section",
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.section"
}
]
},
{
"id": "Composition.section:sectionPlanOfCare",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionPlanOfCare",
"short": "PS-CA Plan of Care Section",
"definition": "The plan of care section contains a narrative description of the expectations for care including proposals, goals, and order requests for monitoring, tracking, or improving the condition of the patient.",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "cmp-1",
"severity": "error",
"human": "A section must contain at least one of text, entries, or sub-sections",
"expression": "text.exists() or entry.exists() or section.exists()",
"xpath": "exists(f:text) or exists(f:entry) or exists(f:section)"
},
{
"key": "cmp-2",
"severity": "error",
"human": "A section can only have an emptyReason if it is empty",
"expression": "emptyReason.empty() or entry.empty()",
"xpath": "not(exists(f:emptyReason) and exists(f:entry))"
},
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.structuredBody.component.section"
}
]
},
{
"id": "Composition.section:sectionPlanOfCare.id",
"path": "Composition.section.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPlanOfCare.extension",
"path": "Composition.section.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPlanOfCare.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPlanOfCare.modifierExtension",
"path": "Composition.section.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.section:sectionPlanOfCare.title",
"path": "Composition.section.title",
"short": "Label for section (e.g. for ToC)",
"definition": "The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.",
"comment": "The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.",
"requirements": "Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.",
"alias": [
"header",
"label",
"caption"
],
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.title",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./title"
},
{
"identity": "cda",
"map": ".title"
}
]
},
{
"id": "Composition.section:sectionPlanOfCare.code",
"path": "Composition.section.code",
"short": "Classification of section (recommended)",
"definition": "A code identifying the kind of content contained within the section. This must be consistent with the section title.",
"comment": "The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.",
"requirements": "Provides computable standardized labels to topics within the document.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "18776-5"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionSectionType"
}
],
"strength": "example",
"description": "Classification of a section of a composition/document.",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes"
},
"mapping": [
{
"identity": "rim",
"map": "./code"
},
{
"identity": "cda",
"map": ".code"
}
]
},
{
"id": "Composition.section:sectionPlanOfCare.author",
"path": "Composition.section.author",
"short": "Who and/or what authored the section",
"definition": "Identifies who is responsible for the information in this section, not necessarily who typed it in.",
"requirements": "Identifies who is responsible for the content.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.author",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "rim",
"map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]"
},
{
"identity": "cda",
"map": ".author.assignedAuthor"
}
]
},
{
"id": "Composition.section:sectionPlanOfCare.focus",
"path": "Composition.section.focus",
"short": "Who/what the section is about, when it is not about the subject of composition",
"definition": "The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).",
"comment": "Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.focus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "cda",
"map": ".subject? (CDA did not differentiate between subject and focus)"
}
]
},
{
"id": "Composition.section:sectionPlanOfCare.text",
"path": "Composition.section.text",
"short": "Text summary of the section, for human interpretation",
"definition": "A human-readable narrative that contains the attested content of the section, 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.",
"comment": "Document profiles may define what content should be represented in the narrative to ensure clinical safety.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".text"
},
{
"identity": "cda",
"map": ".text"
}
]
},
{
"id": "Composition.section:sectionPlanOfCare.mode",
"path": "Composition.section.mode",
"short": "working | snapshot | changes",
"definition": "How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.",
"comment": "This element is labeled as a modifier because a change list must not be misunderstood as a complete list.",
"requirements": "Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.mode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionMode"
}
],
"strength": "required",
"description": "The processing mode that applies to this section.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-mode|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPlanOfCare.orderedBy",
"path": "Composition.section.orderedBy",
"short": "Order of section entries",
"definition": "Specifies the order applied to the items in the section entries.",
"comment": "Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.",
"requirements": "Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.orderedBy",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEntryOrder"
}
],
"strength": "preferred",
"description": "What order applies to the items in the entry.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-order"
},
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPlanOfCare.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Optional entry used to represent structured care plans",
"definition": "Dynamic, personalized plan including identified needed healthcare activity, health objectives and healthcare goals, relating to one or more specified health issues in a healthcare process [Source EN ISO 13940]",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionPlanOfCare.entry:carePlan",
"path": "Composition.section.entry",
"sliceName": "carePlan",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/CarePlan"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionPlanOfCare.entry:documentReference",
"path": "Composition.section.entry",
"sliceName": "documentReference",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/DocumentReference"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionPlanOfCare.emptyReason",
"path": "Composition.section.emptyReason",
"short": "Why the section is empty",
"definition": "If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.",
"comment": "The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.",
"requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEmptyReason"
}
],
"strength": "preferred",
"description": "If a section is empty, why it is empty.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-empty-reason"
},
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPlanOfCare.section",
"path": "Composition.section.section",
"short": "Nested Section",
"definition": "A nested sub-section within this section.",
"comment": "Nested sections are primarily used to help human readers navigate to particular portions of the document.",
"min": 0,
"max": "0",
"base": {
"path": "Composition.section.section",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Composition#Composition.section",
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.section"
}
]
},
{
"id": "Composition.section:sectionSocialHistory",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionSocialHistory",
"short": "PS-CA Social History Section",
"definition": "The social history section contains a description of the person’s Health related \"lifestyle factors\" or \"lifestyle observations\" (e.g., smoke habits; alcohol consumption; diets, risky habits.)",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "cmp-1",
"severity": "error",
"human": "A section must contain at least one of text, entries, or sub-sections",
"expression": "text.exists() or entry.exists() or section.exists()",
"xpath": "exists(f:text) or exists(f:entry) or exists(f:section)"
},
{
"key": "cmp-2",
"severity": "error",
"human": "A section can only have an emptyReason if it is empty",
"expression": "emptyReason.empty() or entry.empty()",
"xpath": "not(exists(f:emptyReason) and exists(f:entry))"
},
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.structuredBody.component.section"
}
]
},
{
"id": "Composition.section:sectionSocialHistory.id",
"path": "Composition.section.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionSocialHistory.extension",
"path": "Composition.section.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionSocialHistory.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionSocialHistory.modifierExtension",
"path": "Composition.section.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.section:sectionSocialHistory.title",
"path": "Composition.section.title",
"short": "Label for section (e.g. for ToC)",
"definition": "The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.",
"comment": "The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.",
"requirements": "Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.",
"alias": [
"header",
"label",
"caption"
],
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.title",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./title"
},
{
"identity": "cda",
"map": ".title"
}
]
},
{
"id": "Composition.section:sectionSocialHistory.code",
"path": "Composition.section.code",
"short": "Classification of section (recommended)",
"definition": "A code identifying the kind of content contained within the section. This must be consistent with the section title.",
"comment": "The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.",
"requirements": "Provides computable standardized labels to topics within the document.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "29762-2"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionSectionType"
}
],
"strength": "example",
"description": "Classification of a section of a composition/document.",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes"
},
"mapping": [
{
"identity": "rim",
"map": "./code"
},
{
"identity": "cda",
"map": ".code"
}
]
},
{
"id": "Composition.section:sectionSocialHistory.author",
"path": "Composition.section.author",
"short": "Who and/or what authored the section",
"definition": "Identifies who is responsible for the information in this section, not necessarily who typed it in.",
"requirements": "Identifies who is responsible for the content.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.author",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "rim",
"map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]"
},
{
"identity": "cda",
"map": ".author.assignedAuthor"
}
]
},
{
"id": "Composition.section:sectionSocialHistory.focus",
"path": "Composition.section.focus",
"short": "Who/what the section is about, when it is not about the subject of composition",
"definition": "The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).",
"comment": "Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.focus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "cda",
"map": ".subject? (CDA did not differentiate between subject and focus)"
}
]
},
{
"id": "Composition.section:sectionSocialHistory.text",
"path": "Composition.section.text",
"short": "Text summary of the section, for human interpretation",
"definition": "A human-readable narrative that contains the attested content of the section, 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.",
"comment": "Document profiles may define what content should be represented in the narrative to ensure clinical safety.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".text"
},
{
"identity": "cda",
"map": ".text"
}
]
},
{
"id": "Composition.section:sectionSocialHistory.mode",
"path": "Composition.section.mode",
"short": "working | snapshot | changes",
"definition": "How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.",
"comment": "This element is labeled as a modifier because a change list must not be misunderstood as a complete list.",
"requirements": "Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.mode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionMode"
}
],
"strength": "required",
"description": "The processing mode that applies to this section.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-mode|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionSocialHistory.orderedBy",
"path": "Composition.section.orderedBy",
"short": "Order of section entries",
"definition": "Specifies the order applied to the items in the section entries.",
"comment": "Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.",
"requirements": "Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.orderedBy",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEntryOrder"
}
],
"strength": "preferred",
"description": "What order applies to the items in the entry.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-order"
},
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionSocialHistory.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Health related \"lifestyle factors\" or \"lifestyle observations\" (e.g., smoke habits; alcohol consumption; diets, risky habits.)",
"definition": "Description of the person’s Health related “lifestyle factors\" or \"lifestyle observations\" (e.g., smoke habits; alcohol consumption; diets, risky habits.)",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionSocialHistory.entry:generalSocialHistory",
"path": "Composition.section.entry",
"sliceName": "generalSocialHistory",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-socialhistory-ca-ps"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionSocialHistory.entry:smokingTobaccoUse",
"path": "Composition.section.entry",
"sliceName": "smokingTobaccoUse",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-tobaccouse-ca-ps"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionSocialHistory.entry:alcoholUse",
"path": "Composition.section.entry",
"sliceName": "alcoholUse",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-alcoholuse-ca-ps"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionSocialHistory.emptyReason",
"path": "Composition.section.emptyReason",
"short": "Why the section is empty",
"definition": "If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.",
"comment": "The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.",
"requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEmptyReason"
}
],
"strength": "preferred",
"description": "If a section is empty, why it is empty.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-empty-reason"
},
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionSocialHistory.section",
"path": "Composition.section.section",
"short": "Nested Section",
"definition": "A nested sub-section within this section.",
"comment": "Nested sections are primarily used to help human readers navigate to particular portions of the document.",
"min": 0,
"max": "0",
"base": {
"path": "Composition.section.section",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Composition#Composition.section",
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.section"
}
]
},
{
"id": "Composition.section:sectionPregnancyHx",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionPregnancyHx",
"short": "PS-CA History of Pregnancy Section",
"definition": "The history of pregnancy section shall contain information about whether the patient is currently pregnant or not.\nIt may contain addition summarizing information about the outcome of earlier pregnancies.",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "cmp-1",
"severity": "error",
"human": "A section must contain at least one of text, entries, or sub-sections",
"expression": "text.exists() or entry.exists() or section.exists()",
"xpath": "exists(f:text) or exists(f:entry) or exists(f:section)"
},
{
"key": "cmp-2",
"severity": "error",
"human": "A section can only have an emptyReason if it is empty",
"expression": "emptyReason.empty() or entry.empty()",
"xpath": "not(exists(f:emptyReason) and exists(f:entry))"
},
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.structuredBody.component.section"
}
]
},
{
"id": "Composition.section:sectionPregnancyHx.id",
"path": "Composition.section.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPregnancyHx.extension",
"path": "Composition.section.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPregnancyHx.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPregnancyHx.modifierExtension",
"path": "Composition.section.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.section:sectionPregnancyHx.title",
"path": "Composition.section.title",
"short": "Label for section (e.g. for ToC)",
"definition": "The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.",
"comment": "The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.",
"requirements": "Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.",
"alias": [
"header",
"label",
"caption"
],
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.title",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./title"
},
{
"identity": "cda",
"map": ".title"
}
]
},
{
"id": "Composition.section:sectionPregnancyHx.code",
"path": "Composition.section.code",
"short": "Classification of section (recommended)",
"definition": "A code identifying the kind of content contained within the section. This must be consistent with the section title.",
"comment": "The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.",
"requirements": "Provides computable standardized labels to topics within the document.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "10162-6"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionSectionType"
}
],
"strength": "example",
"description": "Classification of a section of a composition/document.",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes"
},
"mapping": [
{
"identity": "rim",
"map": "./code"
},
{
"identity": "cda",
"map": ".code"
}
]
},
{
"id": "Composition.section:sectionPregnancyHx.author",
"path": "Composition.section.author",
"short": "Who and/or what authored the section",
"definition": "Identifies who is responsible for the information in this section, not necessarily who typed it in.",
"requirements": "Identifies who is responsible for the content.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.author",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "rim",
"map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]"
},
{
"identity": "cda",
"map": ".author.assignedAuthor"
}
]
},
{
"id": "Composition.section:sectionPregnancyHx.focus",
"path": "Composition.section.focus",
"short": "Who/what the section is about, when it is not about the subject of composition",
"definition": "The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).",
"comment": "Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.focus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "cda",
"map": ".subject? (CDA did not differentiate between subject and focus)"
}
]
},
{
"id": "Composition.section:sectionPregnancyHx.text",
"path": "Composition.section.text",
"short": "Text summary of the section, for human interpretation",
"definition": "A human-readable narrative that contains the attested content of the section, 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.",
"comment": "Document profiles may define what content should be represented in the narrative to ensure clinical safety.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".text"
},
{
"identity": "cda",
"map": ".text"
}
]
},
{
"id": "Composition.section:sectionPregnancyHx.mode",
"path": "Composition.section.mode",
"short": "working | snapshot | changes",
"definition": "How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.",
"comment": "This element is labeled as a modifier because a change list must not be misunderstood as a complete list.",
"requirements": "Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.mode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionMode"
}
],
"strength": "required",
"description": "The processing mode that applies to this section.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-mode|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPregnancyHx.orderedBy",
"path": "Composition.section.orderedBy",
"short": "Order of section entries",
"definition": "Specifies the order applied to the items in the section entries.",
"comment": "Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.",
"requirements": "Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.orderedBy",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEntryOrder"
}
],
"strength": "preferred",
"description": "What order applies to the items in the entry.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-order"
},
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPregnancyHx.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Current pregnancy status and, optionally, information about the outcome of earlier pregnancies.",
"definition": "It contains information about whether the patient is currently pregnant or not.\nIt may contain addition summarizing information about the outcome of earlier pregnancies.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionPregnancyHx.entry:pregnancyStatus",
"path": "Composition.section.entry",
"sliceName": "pregnancyStatus",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "Pending definition of a PS CA pregnancy status observation profile in a future release of PS CA, implementors are encouraged to use the IPS pregnancy status observation profile.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/uv/ips/StructureDefinition/Observation-pregnancy-status-uv-ips"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionPregnancyHx.entry:pregnancyOutcomeSummary",
"path": "Composition.section.entry",
"sliceName": "pregnancyOutcomeSummary",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "Pending definition of a PS CA pregnancy outcome observation profile in a future release of PS CA, implementors are encouraged to use the IPS pregnancy outcome observation profile.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/uv/ips/StructureDefinition/Observation-pregnancy-outcome-uv-ips"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionPregnancyHx.emptyReason",
"path": "Composition.section.emptyReason",
"short": "Why the section is empty",
"definition": "If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.",
"comment": "The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.",
"requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEmptyReason"
}
],
"strength": "preferred",
"description": "If a section is empty, why it is empty.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-empty-reason"
},
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPregnancyHx.section",
"path": "Composition.section.section",
"short": "Nested Section",
"definition": "A nested sub-section within this section.",
"comment": "Nested sections are primarily used to help human readers navigate to particular portions of the document.",
"min": 0,
"max": "0",
"base": {
"path": "Composition.section.section",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Composition#Composition.section",
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.section"
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionAdvanceDirectives",
"short": "PS-CA Advance Directives Section",
"definition": "The advance directives section contains a narrative description of patient's advance directive.",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "cmp-1",
"severity": "error",
"human": "A section must contain at least one of text, entries, or sub-sections",
"expression": "text.exists() or entry.exists() or section.exists()",
"xpath": "exists(f:text) or exists(f:entry) or exists(f:section)"
},
{
"key": "cmp-2",
"severity": "error",
"human": "A section can only have an emptyReason if it is empty",
"expression": "emptyReason.empty() or entry.empty()",
"xpath": "not(exists(f:emptyReason) and exists(f:entry))"
},
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.structuredBody.component.section"
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives.id",
"path": "Composition.section.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives.extension",
"path": "Composition.section.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives.modifierExtension",
"path": "Composition.section.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives.title",
"path": "Composition.section.title",
"short": "Label for section (e.g. for ToC)",
"definition": "The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.",
"comment": "The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.",
"requirements": "Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.",
"alias": [
"header",
"label",
"caption"
],
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.title",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./title"
},
{
"identity": "cda",
"map": ".title"
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives.code",
"path": "Composition.section.code",
"short": "Classification of section (recommended)",
"definition": "A code identifying the kind of content contained within the section. This must be consistent with the section title.",
"comment": "The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.",
"requirements": "Provides computable standardized labels to topics within the document.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "42348-3"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionSectionType"
}
],
"strength": "example",
"description": "Classification of a section of a composition/document.",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes"
},
"mapping": [
{
"identity": "rim",
"map": "./code"
},
{
"identity": "cda",
"map": ".code"
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives.author",
"path": "Composition.section.author",
"short": "Who and/or what authored the section",
"definition": "Identifies who is responsible for the information in this section, not necessarily who typed it in.",
"requirements": "Identifies who is responsible for the content.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.author",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "rim",
"map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]"
},
{
"identity": "cda",
"map": ".author.assignedAuthor"
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives.focus",
"path": "Composition.section.focus",
"short": "Who/what the section is about, when it is not about the subject of composition",
"definition": "The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).",
"comment": "Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.focus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "cda",
"map": ".subject? (CDA did not differentiate between subject and focus)"
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives.text",
"path": "Composition.section.text",
"short": "Text summary of the section, for human interpretation",
"definition": "A human-readable narrative that contains the attested content of the section, 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.",
"comment": "Document profiles may define what content should be represented in the narrative to ensure clinical safety.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".text"
},
{
"identity": "cda",
"map": ".text"
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives.mode",
"path": "Composition.section.mode",
"short": "working | snapshot | changes",
"definition": "How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.",
"comment": "This element is labeled as a modifier because a change list must not be misunderstood as a complete list.",
"requirements": "Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.mode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionMode"
}
],
"strength": "required",
"description": "The processing mode that applies to this section.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-mode|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives.orderedBy",
"path": "Composition.section.orderedBy",
"short": "Order of section entries",
"definition": "Specifies the order applied to the items in the section entries.",
"comment": "Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.",
"requirements": "Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.orderedBy",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEntryOrder"
}
],
"strength": "preferred",
"description": "What order applies to the items in the entry.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-order"
},
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Narrative description of the patient's advance directive.",
"definition": "Contains a narrative description or a Consent entry with information about the patient's advance directive.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent",
"path": "Composition.section.entry",
"sliceName": "advanceDirectivesConsent",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Consent"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesDocumentReference",
"path": "Composition.section.entry",
"sliceName": "advanceDirectivesDocumentReference",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/DocumentReference"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives.emptyReason",
"path": "Composition.section.emptyReason",
"short": "Why the section is empty",
"definition": "If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.",
"comment": "The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.",
"requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEmptyReason"
}
],
"strength": "preferred",
"description": "If a section is empty, why it is empty.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-empty-reason"
},
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives.section",
"path": "Composition.section.section",
"short": "Nested Section",
"definition": "A nested sub-section within this section.",
"comment": "Nested sections are primarily used to help human readers navigate to particular portions of the document.",
"min": 0,
"max": "0",
"base": {
"path": "Composition.section.section",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Composition#Composition.section",
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.section"
}
]
},
{
"id": "Composition.section:sectionFamilyHistory",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionFamilyHistory",
"short": "PS-CA Family History Section",
"definition": "The family history section contains a description of the patient's family history.",
"comment": "This is a new section being introduced by the PS-CA specification at the request of jurisdictions.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "cmp-1",
"severity": "error",
"human": "A section must contain at least one of text, entries, or sub-sections",
"expression": "text.exists() or entry.exists() or section.exists()",
"xpath": "exists(f:text) or exists(f:entry) or exists(f:section)"
},
{
"key": "cmp-2",
"severity": "error",
"human": "A section can only have an emptyReason if it is empty",
"expression": "emptyReason.empty() or entry.empty()",
"xpath": "not(exists(f:emptyReason) and exists(f:entry))"
},
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.structuredBody.component.section"
}
]
},
{
"id": "Composition.section:sectionFamilyHistory.id",
"path": "Composition.section.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionFamilyHistory.extension",
"path": "Composition.section.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionFamilyHistory.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionFamilyHistory.modifierExtension",
"path": "Composition.section.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.section:sectionFamilyHistory.title",
"path": "Composition.section.title",
"short": "Label for section (e.g. for ToC)",
"definition": "The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.",
"comment": "The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.",
"requirements": "Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.",
"alias": [
"header",
"label",
"caption"
],
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.title",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./title"
},
{
"identity": "cda",
"map": ".title"
}
]
},
{
"id": "Composition.section:sectionFamilyHistory.code",
"path": "Composition.section.code",
"short": "Classification of section (recommended)",
"definition": "A code identifying the kind of content contained within the section. This must be consistent with the section title.",
"comment": "The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.",
"requirements": "Provides computable standardized labels to topics within the document.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "10157-6"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionSectionType"
}
],
"strength": "example",
"description": "Classification of a section of a composition/document.",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes"
},
"mapping": [
{
"identity": "rim",
"map": "./code"
},
{
"identity": "cda",
"map": ".code"
}
]
},
{
"id": "Composition.section:sectionFamilyHistory.author",
"path": "Composition.section.author",
"short": "Who and/or what authored the section",
"definition": "Identifies who is responsible for the information in this section, not necessarily who typed it in.",
"requirements": "Identifies who is responsible for the content.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.author",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "rim",
"map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]"
},
{
"identity": "cda",
"map": ".author.assignedAuthor"
}
]
},
{
"id": "Composition.section:sectionFamilyHistory.focus",
"path": "Composition.section.focus",
"short": "Who/what the section is about, when it is not about the subject of composition",
"definition": "The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).",
"comment": "Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.focus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "cda",
"map": ".subject? (CDA did not differentiate between subject and focus)"
}
]
},
{
"id": "Composition.section:sectionFamilyHistory.text",
"path": "Composition.section.text",
"short": "Text summary of the section, for human interpretation",
"definition": "A human-readable narrative that contains the attested content of the section, 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.",
"comment": "Document profiles may define what content should be represented in the narrative to ensure clinical safety.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".text"
},
{
"identity": "cda",
"map": ".text"
}
]
},
{
"id": "Composition.section:sectionFamilyHistory.mode",
"path": "Composition.section.mode",
"short": "working | snapshot | changes",
"definition": "How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.",
"comment": "This element is labeled as a modifier because a change list must not be misunderstood as a complete list.",
"requirements": "Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.mode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionMode"
}
],
"strength": "required",
"description": "The processing mode that applies to this section.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-mode|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionFamilyHistory.orderedBy",
"path": "Composition.section.orderedBy",
"short": "Order of section entries",
"definition": "Specifies the order applied to the items in the section entries.",
"comment": "Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.",
"requirements": "Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.orderedBy",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEntryOrder"
}
],
"strength": "preferred",
"description": "What order applies to the items in the entry.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-order"
},
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionFamilyHistory.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Narrative description of the patient's family history.",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionFamilyHistory.entry:FamilyMemberHistory",
"path": "Composition.section.entry",
"sliceName": "FamilyMemberHistory",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/familymemberhistory-ca-ps"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionFamilyHistory.emptyReason",
"path": "Composition.section.emptyReason",
"short": "Why the section is empty",
"definition": "If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.",
"comment": "The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.",
"requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEmptyReason"
}
],
"strength": "preferred",
"description": "If a section is empty, why it is empty.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-empty-reason"
},
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionFamilyHistory.section",
"path": "Composition.section.section",
"short": "Nested Section",
"definition": "A nested sub-section within this section.",
"comment": "Nested sections are primarily used to help human readers navigate to particular portions of the document.",
"min": 0,
"max": "0",
"base": {
"path": "Composition.section.section",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Composition#Composition.section",
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.section"
}
]
},
{
"id": "Composition.section:sectionPatientStory",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionPatientStory",
"short": "PS-CA Patient Story Section",
"definition": "The section contains narrative text along with optional resources that express what matters to a patient. This may include needs, strengths, values, concerns and preferences to others providing support and care. The patient’s story, provided here, may be told by the patient or by a proxy.",
"comment": "This is a new section being introduced by the PS-CA specification at the request of jurisdictions. While the Patient Story section is relatively unconstrained at this time, information that is better suited to another section should not be included in the Patient Story. For example, DNR orders should be placed in the Advanced Directives section.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "cmp-1",
"severity": "error",
"human": "A section must contain at least one of text, entries, or sub-sections",
"expression": "text.exists() or entry.exists() or section.exists()",
"xpath": "exists(f:text) or exists(f:entry) or exists(f:section)"
},
{
"key": "cmp-2",
"severity": "error",
"human": "A section can only have an emptyReason if it is empty",
"expression": "emptyReason.empty() or entry.empty()",
"xpath": "not(exists(f:emptyReason) and exists(f:entry))"
},
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.structuredBody.component.section"
}
]
},
{
"id": "Composition.section:sectionPatientStory.id",
"path": "Composition.section.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPatientStory.extension",
"path": "Composition.section.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPatientStory.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"comment": "This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPatientStory.modifierExtension",
"path": "Composition.section.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Composition.section:sectionPatientStory.title",
"path": "Composition.section.title",
"short": "Label for section (e.g. for ToC)",
"definition": "The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.",
"comment": "The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.",
"requirements": "Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.",
"alias": [
"header",
"label",
"caption"
],
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.title",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./title"
},
{
"identity": "cda",
"map": ".title"
}
]
},
{
"id": "Composition.section:sectionPatientStory.code",
"path": "Composition.section.code",
"short": "Classification of section (recommended)",
"definition": "A code identifying the kind of content contained within the section. This must be consistent with the section title.",
"comment": "The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. \n\nIf the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.",
"requirements": "Provides computable standardized labels to topics within the document.",
"min": 1,
"max": "1",
"base": {
"path": "Composition.section.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "81338-6"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "CompositionSectionType"
}
],
"strength": "example",
"description": "Classification of a section of a composition/document.",
"valueSet": "http://hl7.org/fhir/ValueSet/doc-section-codes"
},
"mapping": [
{
"identity": "rim",
"map": "./code"
},
{
"identity": "cda",
"map": ".code"
}
]
},
{
"id": "Composition.section:sectionPatientStory.author",
"path": "Composition.section.author",
"short": "Who and/or what authored the section",
"definition": "Identifies who is responsible for the information in this section, not necessarily who typed it in.",
"requirements": "Identifies who is responsible for the content.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.author",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "rim",
"map": ".participation[typeCode=\"AUT\"].role[classCode=\"ASSIGNED\"]"
},
{
"identity": "cda",
"map": ".author.assignedAuthor"
}
]
},
{
"id": "Composition.section:sectionPatientStory.focus",
"path": "Composition.section.focus",
"short": "Who/what the section is about, when it is not about the subject of composition",
"definition": "The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).",
"comment": "Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.focus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "cda",
"map": ".subject? (CDA did not differentiate between subject and focus)"
}
]
},
{
"id": "Composition.section:sectionPatientStory.text",
"path": "Composition.section.text",
"short": "Text summary of the section, for human interpretation",
"definition": "A human-readable narrative that contains the attested content of the section, 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.",
"comment": "Document profiles may define what content should be represented in the narrative to ensure clinical safety.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".text"
},
{
"identity": "cda",
"map": ".text"
}
]
},
{
"id": "Composition.section:sectionPatientStory.mode",
"path": "Composition.section.mode",
"short": "working | snapshot | changes",
"definition": "How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.",
"comment": "This element is labeled as a modifier because a change list must not be misunderstood as a complete list.",
"requirements": "Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.mode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionMode"
}
],
"strength": "required",
"description": "The processing mode that applies to this section.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-mode|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPatientStory.orderedBy",
"path": "Composition.section.orderedBy",
"short": "Order of section entries",
"definition": "Specifies the order applied to the items in the section entries.",
"comment": "Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.",
"requirements": "Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.orderedBy",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEntryOrder"
}
],
"strength": "preferred",
"description": "What order applies to the items in the entry.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-order"
},
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPatientStory.entry",
"path": "Composition.section.entry",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"comment": "If there are no entries in the list, an emptyReason SHOULD be provided.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.entry",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]"
},
{
"identity": "cda",
"map": ".entry"
}
]
},
{
"id": "Composition.section:sectionPatientStory.emptyReason",
"path": "Composition.section.emptyReason",
"short": "Why the section is empty",
"definition": "If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.",
"comment": "The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.",
"requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.",
"min": 0,
"max": "1",
"base": {
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"cmp-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SectionEmptyReason"
}
],
"strength": "preferred",
"description": "If a section is empty, why it is empty.",
"valueSet": "http://hl7.org/fhir/ValueSet/list-empty-reason"
},
"mapping": [
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Composition.section:sectionPatientStory.section",
"path": "Composition.section.section",
"short": "Nested Section",
"definition": "A nested sub-section within this section.",
"comment": "Nested sections are primarily used to help human readers navigate to particular portions of the document.",
"min": 0,
"max": "*",
"base": {
"path": "Composition.section.section",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Composition#Composition.section",
"condition": [
"cmp-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./outboundRelationship[typeCode=\"COMP\" and isNormalActRelationship()]/target[moodCode=\"EVN\" and classCode=\"DOCSECT\" and isNormalAct]"
},
{
"identity": "cda",
"map": ".component.section"
}
]
}
]
},
"differential": {
"element": [
{
"id": "Composition",
"path": "Composition",
"short": "Canadian Patient Summary composition",
"definition": "Canadian Patient Summary composition.\nA composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement.\nWhile a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained."
},
{
"id": "Composition.text",
"path": "Composition.text",
"comment": "PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.",
"mustSupport": true
},
{
"id": "Composition.identifier",
"path": "Composition.identifier",
"mustSupport": true
},
{
"id": "Composition.status",
"path": "Composition.status",
"mustSupport": true
},
{
"id": "Composition.type",
"path": "Composition.type",
"short": "Kind of composition (\"Patient Summary\")",
"definition": "Specifies that this composition refers to a Patient Summary (Loinc \"60591-5\")",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "60591-5"
}
]
},
"mustSupport": true
},
{
"id": "Composition.subject",
"path": "Composition.subject",
"definition": "Who or what the composition is about.\nIn general a composition 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 livestock, or a set of patients that share a common exposure).\nFor the PS the subject is always the patient.",
"min": 1,
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps"
]
}
],
"mustSupport": true
},
{
"id": "Composition.subject.reference",
"path": "Composition.subject.reference",
"min": 1,
"mustSupport": true
},
{
"id": "Composition.encounter",
"path": "Composition.encounter",
"comment": "While IPS-UV considers this a Must Support element, policy has not yet been developed in Canada confirming the expectations for when a patient summary is created (e.g., does it have to be created by a health professional or just validated, can it be automatically assembled, does it have to occur within an encounter, etc.). This relaxation does not exclude or prevent implementers from further defining how encounter is used in their implementation if their use case(s) rely on its presence."
},
{
"id": "Composition.date",
"path": "Composition.date",
"mustSupport": true
},
{
"id": "Composition.author",
"path": "Composition.author",
"short": "Who and/or what authored the patient summary",
"definition": "Identifies who is responsible for the information in the patient summary, not necessarily who typed it in.\n\nThe type of author(s) contribute to determine the \"nature\"of the Patient Summary: e.g., a \"human-curated\" PS Vs. an \"automatically generated\" PS.",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner",
"http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization"
]
}
],
"mustSupport": true
},
{
"id": "Composition.title",
"path": "Composition.title",
"short": "CA Patient Summary",
"definition": "Official human-readable label for the composition.\n\nFor this document should be \"CA Patient Summary\" or any equivalent translation",
"mustSupport": true
},
{
"id": "Composition.confidentiality",
"path": "Composition.confidentiality"
},
{
"id": "Composition.attester",
"path": "Composition.attester",
"comment": "IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported across workflows of Canadian jurisdictional implementers. \n\n These challenges have been raised in IPS. Further assessment of jurisdictional use cases need to be explored by the Patient Summary Working Group before the constraint will be re-considered for inclusion"
},
{
"id": "Composition.attester.mode",
"path": "Composition.attester.mode",
"comment": "While Composition.attester is not currently flagged as Must Support in PS-CA, Implementers who support attester are expected to support attester.mode, attester.time, and attester.party",
"mustSupport": true
},
{
"id": "Composition.attester.time",
"path": "Composition.attester.time",
"comment": "While Composition.attester is not currently flagged as Must Support in PS-CA, Implementers who support attester are expected to support attester.mode, attester.time, and attester.party",
"mustSupport": true
},
{
"id": "Composition.attester.party",
"path": "Composition.attester.party",
"comment": "While Composition.attester is not currently flagged as Must Support in PS-CA, Implementers who support attester are expected to support attester.mode, attester.time, and attester.party",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner",
"http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole",
"http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization"
]
}
],
"mustSupport": true
},
{
"id": "Composition.custodian",
"path": "Composition.custodian",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization"
]
}
],
"mustSupport": true
},
{
"id": "Composition.relatesTo",
"path": "Composition.relatesTo"
},
{
"id": "Composition.relatesTo.code",
"path": "Composition.relatesTo.code"
},
{
"id": "Composition.relatesTo.target[x]",
"path": "Composition.relatesTo.target[x]",
"type": [
{
"code": "Identifier"
},
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Composition",
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps"
]
}
]
},
{
"id": "Composition.event",
"path": "Composition.event",
"slicing": {
"discriminator": [
{
"type": "pattern",
"path": "code"
}
],
"rules": "open"
},
"definition": "IPS Note: The main activity being described by a PS is the provision of healthcare over a period of time. In the CDA representation of the PS this is shown by setting the value of serviceEvent/@classCode to “PCPR” (care provision) and indicating the duration over which care was provided in serviceEvent/effectiveTime. In the FHIR representation at least one event should be used to record this information. Additional data from outside this duration may also be included if it is relevant to care provided during that time range (e.g., reviewed during the stated time range). For example if the PS is generated by a GP based on information recorded in his/her EHR-S, then the start value should represent the date when the treatment relationship between the patient and the GP started; and the end value the date of the latest care event."
},
{
"id": "Composition.event:careProvisioningEvent",
"path": "Composition.event",
"sliceName": "careProvisioningEvent",
"short": "The care provisioning being documented",
"definition": "The provision of healthcare over a period of time this PS is documented.",
"max": "1"
},
{
"id": "Composition.event:careProvisioningEvent.code",
"path": "Composition.event.code",
"comment": "While Composition.event:careProvisioningEvent slice is not currently flagged as Must Support in PS-CA, Implementers who support the slice are expected to support Composition.event:careProvisioningEvent.code and Composition.event:careProvisioningEvent.period",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActClass",
"code": "PCPR"
}
]
},
"mustSupport": true
},
{
"id": "Composition.event:careProvisioningEvent.period",
"path": "Composition.event.period",
"comment": "While Composition.event:careProvisioningEvent slice is not currently flagged as Must Support in PS-CA, Implementers who support the slice are expected to support Composition.event:careProvisioningEvent.code and Composition.event:careProvisioningEvent.period",
"mustSupport": true
},
{
"id": "Composition.section",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"slicing": {
"discriminator": [
{
"type": "pattern",
"path": "code"
}
],
"ordered": false,
"rules": "open"
},
"short": "Sections composing the PS",
"definition": "The root of the sections that make up the PS-CA composition.",
"min": 1,
"mustSupport": true
},
{
"id": "Composition.section.extension",
"path": "Composition.section.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
}
},
{
"id": "Composition.section.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
]
},
{
"id": "Composition.section.code",
"path": "Composition.section.code",
"min": 1,
"type": [
{
"code": "CodeableConcept",
"profile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps"
]
}
],
"mustSupport": true
},
{
"id": "Composition.section.text",
"path": "Composition.section.text",
"comment": "PS-CA is following IPS guidence regarding text and section.text. It is reccomended that documents do not duplicate the content in Composition.section.text with content in Composition.text.",
"min": 1,
"mustSupport": true
},
{
"id": "Composition.section.emptyReason",
"path": "Composition.section.emptyReason"
},
{
"id": "Composition.section:sectionMedications",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionMedications",
"short": "PS-CA Medication Summary Section",
"definition": "The medication summary section contains a description of the patient's medications relevant for the scope of the patient summary. The actual content could depend on the jurisdiction, it could report:\n- the currently active medications;\n- the current and past medications considered relevant by the authoring GP;\n- the patient prescriptions or dispensations automatically extracted by a regional or a national EHR.\n\nBecause This section has been expanded in the PS-CA to model a medicationRequest profile in addition to medicationStatement profile initially included in IPS-UV.",
"comment": "IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of data - though has recently updated to allow for the provision of section.emptyReason. This constraint has been maintained in the PS-CA. Systems should utilize the section.entry with a resource when conveying that the subject has no known medications (e.g., clinical assertions that are captured alongside supportive data like date). The section.emptyReason is available to convey details for why the section entry is empty (e.g., data unavailable).",
"min": 1,
"max": "1",
"constraint": [
{
"key": "ips-comp-1",
"severity": "error",
"human": "Either section.entry or emptyReason are present",
"expression": "(entry.reference.exists() or emptyReason.exists())",
"xpath": "(/f:entry.reference and not /f:emptyReason) or (not(/f:emptyReason) and /f:entry.reference)"
}
],
"mustSupport": true
},
{
"id": "Composition.section:sectionMedications.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
]
},
{
"id": "Composition.section:sectionMedications.title",
"path": "Composition.section.title",
"short": "Medication Summary section",
"definition": "The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.\n\nMedication Summary",
"min": 1,
"mustSupport": true
},
{
"id": "Composition.section:sectionMedications.code",
"path": "Composition.section.code",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "10160-0"
}
]
},
"mustSupport": true
},
{
"id": "Composition.section:sectionMedications.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Medications relevant for the scope of the patient summary",
"definition": "This list the medications relevant for the scope of the patient summary or it is used to indicate that the subject is known not to be on any relevant medication",
"comment": "This entry requires a medicationStatement or a medicationRequest.",
"mustSupport": true
},
{
"id": "Composition.section:sectionMedications.entry:medicationStatement",
"path": "Composition.section.entry",
"sliceName": "medicationStatement",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/medicationstatement-ca-ps"
]
}
]
},
{
"id": "Composition.section:sectionMedications.entry:medicationRequest",
"path": "Composition.section.entry",
"sliceName": "medicationRequest",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/medicationrequest-ca-ps"
]
}
]
},
{
"id": "Composition.section:sectionMedications.emptyReason",
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1",
"mustSupport": true
},
{
"id": "Composition.section:sectionMedications.section",
"path": "Composition.section.section",
"max": "0"
},
{
"id": "Composition.section:sectionAllergies",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionAllergies",
"short": "PS-CA Allergies and Intolerances Section",
"definition": "This section documents the relevant allergies or intolerances (conditions) for that patient, describing the kind of reaction (e.g., rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy.\nAt a minimum, it should list currently active and any relevant historical allergies and adverse reactions.\nIf no information about allergies is available, or if no allergies are known this should be clearly documented in the section.",
"comment": "IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of data - though has recently updated to allow for the provision of section.emptyReason. This constraint has been maintained in the PS-CA. Systems should utilize the section.entry with a resource when conveying that the subject has no known allergies (e.g., clinical assertions that are captured alongside supportive data like date). The section.emptyReason is available to convey details for why the section entry is empty (e.g., data unavailable).",
"min": 1,
"max": "1",
"constraint": [
{
"key": "ips-comp-1",
"severity": "error",
"human": "Either section.entry or emptyReason are present",
"expression": "(entry.reference.exists() or emptyReason.exists())",
"xpath": "(/f:entry.reference and not /f:emptyReason) or (not(/f:emptyReason) and /f:entry.reference)"
}
],
"mustSupport": true
},
{
"id": "Composition.section:sectionAllergies.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
]
},
{
"id": "Composition.section:sectionAllergies.title",
"path": "Composition.section.title",
"short": "Allergies and Intolerances",
"min": 1,
"mustSupport": true
},
{
"id": "Composition.section:sectionAllergies.code",
"path": "Composition.section.code",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "48765-2"
}
]
},
"mustSupport": true
},
{
"id": "Composition.section:sectionAllergies.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Relevant allergies or intolerances (conditions) for that patient.",
"definition": "It lists the relevant allergies or intolerances (conditions) for that patient, describing the kind of reaction (e.g., rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy.\nAt a minimum, it should list currently active and any relevant historical allergies and adverse reactions.",
"mustSupport": true
},
{
"id": "Composition.section:sectionAllergies.entry:allergyOrIntolerance",
"path": "Composition.section.entry",
"sliceName": "allergyOrIntolerance",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/allergyintolerance-ca-ps"
]
}
]
},
{
"id": "Composition.section:sectionAllergies.emptyReason",
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1",
"mustSupport": true
},
{
"id": "Composition.section:sectionAllergies.section",
"path": "Composition.section.section",
"max": "0"
},
{
"id": "Composition.section:sectionProblems",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionProblems",
"short": "PS-CA Problems Section",
"definition": "The PS problem section lists and describes clinical problems or conditions currently being monitored for the patient.",
"comment": "IPS-UV requires a minimum cardinality of 1 on this section to ensure it is always populated with some kind of data - though has recently updated to allow for the provision of section.emptyReason. This constraint has been maintained in the PS-CA. Systems should utilize the section.entry with a resource when conveying that the subject has no known conditions (e.g., clinical assertions that are captured alongside supportive data like date). The section.emptyReason is available to convey details for why the section entry is empty (e.g., data unavailable).",
"min": 1,
"max": "1",
"constraint": [
{
"key": "ips-comp-1",
"severity": "error",
"human": "Either section.entry or emptyReason are present",
"expression": "(entry.reference.exists() or emptyReason.exists())",
"xpath": "(/f:entry.reference and not /f:emptyReason) or (not(/f:emptyReason) and /f:entry.reference)"
}
],
"mustSupport": true
},
{
"id": "Composition.section:sectionProblems.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
]
},
{
"id": "Composition.section:sectionProblems.title",
"path": "Composition.section.title",
"min": 1,
"mustSupport": true
},
{
"id": "Composition.section:sectionProblems.code",
"path": "Composition.section.code",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "11450-4"
}
]
},
"mustSupport": true
},
{
"id": "Composition.section:sectionProblems.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Clinical problems or conditions currently being monitored for the patient.",
"definition": "It lists and describes clinical problems or conditions currently being monitored for the patient.",
"mustSupport": true
},
{
"id": "Composition.section:sectionProblems.entry:problem",
"path": "Composition.section.entry",
"sliceName": "problem",
"short": "A reference to data that supports this section",
"definition": "A reference to the actual resource from which the narrative in the section is derived.",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/condition-ca-ps"
]
}
]
},
{
"id": "Composition.section:sectionProblems.emptyReason",
"path": "Composition.section.emptyReason",
"min": 0,
"max": "1",
"mustSupport": true
},
{
"id": "Composition.section:sectionProblems.section",
"path": "Composition.section.section",
"max": "0"
},
{
"id": "Composition.section:sectionProceduresHx",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionProceduresHx",
"short": "PS-CA History of Procedures Section",
"definition": "The History of Procedures Section contains a description of the patient past procedures that are pertinent to the scope of this document.\nProcedures may refer for example to:\n1. Invasive Diagnostic procedure: e.g., Cardiac catheterization; (the results of these procedure are documented in the results section)\n2. Therapeutic procedure: e.g., dialysis;\n3. Surgical procedure: e.g., appendectomy",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content",
"max": "1"
},
{
"id": "Composition.section:sectionProceduresHx.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
]
},
{
"id": "Composition.section:sectionProceduresHx.title",
"path": "Composition.section.title",
"min": 1,
"mustSupport": true
},
{
"id": "Composition.section:sectionProceduresHx.code",
"path": "Composition.section.code",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "47519-4"
}
]
},
"mustSupport": true
},
{
"id": "Composition.section:sectionProceduresHx.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Patient past procedures pertinent to the scope of this document.",
"definition": "It lists the patient past procedures that are pertinent to the scope of this document.\nProcedures may refer for example to:\n1. Invasive Diagnostic procedure: e.g., Cardiac catheterization; (the results of these procedure are documented in the results section)\n2. Therapeutic procedure: e.g., dialysis;\n3. Surgical procedure: e.g., appendectomy.",
"mustSupport": true
},
{
"id": "Composition.section:sectionProceduresHx.entry:procedure",
"path": "Composition.section.entry",
"sliceName": "procedure",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/procedure-ca-ps"
]
}
],
"mustSupport": true
},
{
"id": "Composition.section:sectionProceduresHx.section",
"path": "Composition.section.section",
"max": "0"
},
{
"id": "Composition.section:sectionImmunizations",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionImmunizations",
"short": "PS-CA Immunizations Section",
"definition": "The Immunizations Section defines a patient's current immunization status and pertinent immunization history.\nThe primary use case for the Immunization Section is to enable communication of a patient's immunization status.\nThe section includes the current immunization status, and may contain the entire immunization history that is relevant to the period of time being summarized.",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content",
"max": "1"
},
{
"id": "Composition.section:sectionImmunizations.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
]
},
{
"id": "Composition.section:sectionImmunizations.title",
"path": "Composition.section.title",
"min": 1,
"mustSupport": true
},
{
"id": "Composition.section:sectionImmunizations.code",
"path": "Composition.section.code",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "11369-6"
}
]
},
"mustSupport": true
},
{
"id": "Composition.section:sectionImmunizations.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Patient's immunization status and pertinent history.",
"definition": "It defines the patient's current immunization status and pertinent immunization history.\nThe primary use case for the Immunization Section is to enable communication of a patient's immunization status.\nIt may contain the entire immunization history that is relevant to the period of time being summarized.",
"mustSupport": true
},
{
"id": "Composition.section:sectionImmunizations.entry:immunization",
"path": "Composition.section.entry",
"sliceName": "immunization",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/immunization-ca-ps"
]
}
],
"mustSupport": true
},
{
"id": "Composition.section:sectionImmunizations.section",
"path": "Composition.section.section",
"max": "0"
},
{
"id": "Composition.section:sectionMedicalDevices",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionMedicalDevices",
"short": "PS-CA Medical Devices Section",
"definition": "The medical devices section contains narrative text and coded entries describing the patient history of medical device use.",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries, future releases may further constrain this section as more jurisdictions look to support its use",
"max": "1"
},
{
"id": "Composition.section:sectionMedicalDevices.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
]
},
{
"id": "Composition.section:sectionMedicalDevices.title",
"path": "Composition.section.title",
"min": 1,
"mustSupport": true
},
{
"id": "Composition.section:sectionMedicalDevices.code",
"path": "Composition.section.code",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "46264-8"
}
]
},
"mustSupport": true
},
{
"id": "Composition.section:sectionMedicalDevices.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Patient history of medical device use.",
"definition": "It describes the patient history of medical device use. This entry shall be used to document that no information about medical device use is available, or that no relevant medical device use is known.",
"mustSupport": true
},
{
"id": "Composition.section:sectionMedicalDevices.entry:deviceStatement",
"path": "Composition.section.entry",
"sliceName": "deviceStatement",
"comment": "Pending definition of a PS CA device use section profile in a future release of PS CA, implementors are encouraged to use the IPS device use section profile.",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/uv/ips/StructureDefinition/DeviceUseStatement-uv-ips"
]
}
],
"mustSupport": true
},
{
"id": "Composition.section:sectionMedicalDevices.section",
"path": "Composition.section.section",
"max": "0"
},
{
"id": "Composition.section:sectionResults",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Results Section"
}
],
"path": "Composition.section",
"sliceName": "sectionResults",
"short": "PS-CA Results Section",
"definition": "This section assembles relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. Some of these results may be laboratory results, others may be anatomic pathology results, others, radiology results, and others, clinical results.",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content",
"max": "1"
},
{
"id": "Composition.section:sectionResults.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
]
},
{
"id": "Composition.section:sectionResults.title",
"path": "Composition.section.title",
"min": 1,
"mustSupport": true
},
{
"id": "Composition.section:sectionResults.code",
"path": "Composition.section.code",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "30954-2"
}
]
},
"mustSupport": true
},
{
"id": "Composition.section:sectionResults.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient.",
"definition": "Relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. Some of these results may be laboratory results, others may be anatomic pathology results, others, radiology results, and others, clinical results.",
"mustSupport": true
},
{
"id": "Composition.section:sectionResults.entry:results-observation-laboratory-pathology",
"path": "Composition.section.entry",
"sliceName": "results-observation-laboratory-pathology",
"min": 0,
"max": "*",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-results-laboratory-pathology-ca-ps"
]
}
],
"mustSupport": true
},
{
"id": "Composition.section:sectionResults.entry:results-observation-radiology",
"path": "Composition.section.entry",
"sliceName": "results-observation-radiology",
"min": 0,
"max": "*",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-results-radiology-ca-ps"
]
}
],
"mustSupport": true
},
{
"id": "Composition.section:sectionResults.entry:results-diagnosticReport",
"path": "Composition.section.entry",
"sliceName": "results-diagnosticReport",
"comment": "Pending definition of a PS CA diagnostic report profile in a future release of PS CA, implementors are encouraged to use the IPS diagnostic report profile.",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/diagnosticreport-ca-ps"
]
}
],
"mustSupport": true
},
{
"id": "Composition.section:sectionResults.section",
"path": "Composition.section.section",
"max": "0"
},
{
"id": "Composition.section:sectionVitalSigns",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Vital Signs Section"
}
],
"path": "Composition.section",
"sliceName": "sectionVitalSigns",
"label": "Vital signs",
"short": "PS-CA Vital Signs Section",
"definition": "The Vital signs section includes blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content",
"max": "1"
},
{
"id": "Composition.section:sectionVitalSigns.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
]
},
{
"id": "Composition.section:sectionVitalSigns.title",
"path": "Composition.section.title",
"min": 1,
"mustSupport": true
},
{
"id": "Composition.section:sectionVitalSigns.code",
"path": "Composition.section.code",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "8716-3"
}
]
},
"mustSupport": true
},
{
"id": "Composition.section:sectionVitalSigns.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Notable vital signs or physical findings.",
"definition": "Notable vital signs or physical findings as: blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included",
"comment": "IPS-UV and PS-CA point to the parent vital signs profile (http://hl7.org/fhir/StructureDefinition/vitalsigns) in the base FHIR specification, it is up to the jurisdictions to select and support the individual vital sign profiles. However, to support implementers in validation - the individual vital signs profiles have been included as individual slices below. The parent vital signs profile has been removed as a slice to prevent examples from matching multiple slices.",
"mustSupport": true
},
{
"id": "Composition.section:sectionVitalSigns.entry:BMI",
"path": "Composition.section.entry",
"sliceName": "BMI",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/bmi"
]
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry:BP",
"path": "Composition.section.entry",
"sliceName": "BP",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/bp"
]
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry:BodyHeight",
"path": "Composition.section.entry",
"sliceName": "BodyHeight",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/bodyheight"
]
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry:BodyTemp",
"path": "Composition.section.entry",
"sliceName": "BodyTemp",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/bodytemp"
]
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry:BodyWeight",
"path": "Composition.section.entry",
"sliceName": "BodyWeight",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/bodyweight"
]
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry:HeadCircum",
"path": "Composition.section.entry",
"sliceName": "HeadCircum",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/headcircum"
]
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry:HeartRate",
"path": "Composition.section.entry",
"sliceName": "HeartRate",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/heartrate"
]
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry:OxygenSat",
"path": "Composition.section.entry",
"sliceName": "OxygenSat",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/oxygensat"
]
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry:RespRate",
"path": "Composition.section.entry",
"sliceName": "RespRate",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/resprate"
]
}
]
},
{
"id": "Composition.section:sectionVitalSigns.entry:VitalsPanel",
"path": "Composition.section.entry",
"sliceName": "VitalsPanel",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/vitalspanel"
]
}
]
},
{
"id": "Composition.section:sectionVitalSigns.section",
"path": "Composition.section.section",
"max": "0"
},
{
"id": "Composition.section:sectionPastIllnessHx",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionPastIllnessHx",
"short": "PS-CA History of Past Illness Section",
"definition": "The History of Past Illness section contains a description of the conditions the patient suffered in the past.",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content",
"max": "1"
},
{
"id": "Composition.section:sectionPastIllnessHx.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
]
},
{
"id": "Composition.section:sectionPastIllnessHx.title",
"path": "Composition.section.title",
"min": 1,
"mustSupport": true
},
{
"id": "Composition.section:sectionPastIllnessHx.code",
"path": "Composition.section.code",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "11348-0"
}
]
},
"mustSupport": true
},
{
"id": "Composition.section:sectionPastIllnessHx.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Conditions the patient suffered in the past.",
"definition": "It contains a description of the conditions the patient suffered in the past.",
"mustSupport": true
},
{
"id": "Composition.section:sectionPastIllnessHx.entry:pastProblem",
"path": "Composition.section.entry",
"sliceName": "pastProblem",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/condition-ca-ps"
]
}
],
"mustSupport": true
},
{
"id": "Composition.section:sectionPastIllnessHx.section",
"path": "Composition.section.section",
"max": "0"
},
{
"id": "Composition.section:sectionFunctionalStatus",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionFunctionalStatus",
"short": "PS-CA Functional Status",
"definition": "The functional status section shall contain a narrative description of capability of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments.\nProfiles to express disabilities and functional assessments will be specified by future versions of this guide.",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error.",
"max": "1"
},
{
"id": "Composition.section:sectionFunctionalStatus.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
]
},
{
"id": "Composition.section:sectionFunctionalStatus.title",
"path": "Composition.section.title",
"min": 1,
"mustSupport": true
},
{
"id": "Composition.section:sectionFunctionalStatus.code",
"path": "Composition.section.code",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "47420-5"
}
]
},
"mustSupport": true
},
{
"id": "Composition.section:sectionFunctionalStatus.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Optional entry used to represent disabilities and functional assessments",
"definition": "It describes capabilities of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments.\nProfiles to express disabilities and functional assessments will be specified by future versions of this guide.",
"mustSupport": true
},
{
"id": "Composition.section:sectionFunctionalStatus.entry:disability",
"path": "Composition.section.entry",
"sliceName": "disability",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/condition-ca-ps"
]
}
],
"mustSupport": true
},
{
"id": "Composition.section:sectionFunctionalStatus.entry:functionalAssessment",
"path": "Composition.section.entry",
"sliceName": "functionalAssessment",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/ClinicalImpression"
]
}
],
"mustSupport": true
},
{
"id": "Composition.section:sectionFunctionalStatus.section",
"path": "Composition.section.section",
"max": "0"
},
{
"id": "Composition.section:sectionPlanOfCare",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionPlanOfCare",
"short": "PS-CA Plan of Care Section",
"definition": "The plan of care section contains a narrative description of the expectations for care including proposals, goals, and order requests for monitoring, tracking, or improving the condition of the patient.",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error.",
"max": "1"
},
{
"id": "Composition.section:sectionPlanOfCare.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
]
},
{
"id": "Composition.section:sectionPlanOfCare.title",
"path": "Composition.section.title",
"min": 1,
"mustSupport": true
},
{
"id": "Composition.section:sectionPlanOfCare.code",
"path": "Composition.section.code",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "18776-5"
}
]
},
"mustSupport": true
},
{
"id": "Composition.section:sectionPlanOfCare.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Optional entry used to represent structured care plans",
"definition": "Dynamic, personalized plan including identified needed healthcare activity, health objectives and healthcare goals, relating to one or more specified health issues in a healthcare process [Source EN ISO 13940]",
"mustSupport": true
},
{
"id": "Composition.section:sectionPlanOfCare.entry:carePlan",
"path": "Composition.section.entry",
"sliceName": "carePlan",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/CarePlan"
]
}
]
},
{
"id": "Composition.section:sectionPlanOfCare.entry:documentReference",
"path": "Composition.section.entry",
"sliceName": "documentReference",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/DocumentReference"
]
}
]
},
{
"id": "Composition.section:sectionPlanOfCare.section",
"path": "Composition.section.section",
"max": "0"
},
{
"id": "Composition.section:sectionSocialHistory",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionSocialHistory",
"short": "PS-CA Social History Section",
"definition": "The social history section contains a description of the person’s Health related \"lifestyle factors\" or \"lifestyle observations\" (e.g., smoke habits; alcohol consumption; diets, risky habits.)",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error. Additionally vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content",
"max": "1"
},
{
"id": "Composition.section:sectionSocialHistory.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
]
},
{
"id": "Composition.section:sectionSocialHistory.title",
"path": "Composition.section.title",
"min": 1,
"mustSupport": true
},
{
"id": "Composition.section:sectionSocialHistory.code",
"path": "Composition.section.code",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "29762-2"
}
]
},
"mustSupport": true
},
{
"id": "Composition.section:sectionSocialHistory.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Health related \"lifestyle factors\" or \"lifestyle observations\" (e.g., smoke habits; alcohol consumption; diets, risky habits.)",
"definition": "Description of the person’s Health related “lifestyle factors\" or \"lifestyle observations\" (e.g., smoke habits; alcohol consumption; diets, risky habits.)",
"mustSupport": true
},
{
"id": "Composition.section:sectionSocialHistory.entry:generalSocialHistory",
"path": "Composition.section.entry",
"sliceName": "generalSocialHistory",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-socialhistory-ca-ps"
]
}
]
},
{
"id": "Composition.section:sectionSocialHistory.entry:smokingTobaccoUse",
"path": "Composition.section.entry",
"sliceName": "smokingTobaccoUse",
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-tobaccouse-ca-ps"
]
}
]
},
{
"id": "Composition.section:sectionSocialHistory.entry:alcoholUse",
"path": "Composition.section.entry",
"sliceName": "alcoholUse",
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-alcoholuse-ca-ps"
]
}
]
},
{
"id": "Composition.section:sectionSocialHistory.section",
"path": "Composition.section.section",
"max": "0"
},
{
"id": "Composition.section:sectionPregnancyHx",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionPregnancyHx",
"short": "PS-CA History of Pregnancy Section",
"definition": "The history of pregnancy section shall contain information about whether the patient is currently pregnant or not.\nIt may contain addition summarizing information about the outcome of earlier pregnancies.",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries. Participating jurisdictions are expected to be able to receive this section in a patient summary without flagging an error.",
"max": "1"
},
{
"id": "Composition.section:sectionPregnancyHx.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
]
},
{
"id": "Composition.section:sectionPregnancyHx.title",
"path": "Composition.section.title",
"min": 1,
"mustSupport": true
},
{
"id": "Composition.section:sectionPregnancyHx.code",
"path": "Composition.section.code",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "10162-6"
}
]
},
"mustSupport": true
},
{
"id": "Composition.section:sectionPregnancyHx.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Current pregnancy status and, optionally, information about the outcome of earlier pregnancies.",
"definition": "It contains information about whether the patient is currently pregnant or not.\nIt may contain addition summarizing information about the outcome of earlier pregnancies.",
"mustSupport": true
},
{
"id": "Composition.section:sectionPregnancyHx.entry:pregnancyStatus",
"path": "Composition.section.entry",
"sliceName": "pregnancyStatus",
"comment": "Pending definition of a PS CA pregnancy status observation profile in a future release of PS CA, implementors are encouraged to use the IPS pregnancy status observation profile.",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/uv/ips/StructureDefinition/Observation-pregnancy-status-uv-ips"
]
}
],
"mustSupport": true
},
{
"id": "Composition.section:sectionPregnancyHx.entry:pregnancyOutcomeSummary",
"path": "Composition.section.entry",
"sliceName": "pregnancyOutcomeSummary",
"comment": "Pending definition of a PS CA pregnancy outcome observation profile in a future release of PS CA, implementors are encouraged to use the IPS pregnancy outcome observation profile.",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/uv/ips/StructureDefinition/Observation-pregnancy-outcome-uv-ips"
]
}
],
"mustSupport": true
},
{
"id": "Composition.section:sectionPregnancyHx.section",
"path": "Composition.section.section",
"max": "0"
},
{
"id": "Composition.section:sectionAdvanceDirectives",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionAdvanceDirectives",
"short": "PS-CA Advance Directives Section",
"definition": "The advance directives section contains a narrative description of patient's advance directive.",
"comment": "IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to allow for jurisdictions who will not be including this domain/section in their initial implementation of patient summaries.",
"max": "1"
},
{
"id": "Composition.section:sectionAdvanceDirectives.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives.title",
"path": "Composition.section.title",
"min": 1,
"mustSupport": true
},
{
"id": "Composition.section:sectionAdvanceDirectives.code",
"path": "Composition.section.code",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "42348-3"
}
]
},
"mustSupport": true
},
{
"id": "Composition.section:sectionAdvanceDirectives.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Narrative description of the patient's advance directive.",
"definition": "Contains a narrative description or a Consent entry with information about the patient's advance directive.",
"mustSupport": true
},
{
"id": "Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent",
"path": "Composition.section.entry",
"sliceName": "advanceDirectivesConsent",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Consent"
]
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesDocumentReference",
"path": "Composition.section.entry",
"sliceName": "advanceDirectivesDocumentReference",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/DocumentReference"
]
}
]
},
{
"id": "Composition.section:sectionAdvanceDirectives.section",
"path": "Composition.section.section",
"max": "0"
},
{
"id": "Composition.section:sectionFamilyHistory",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionFamilyHistory",
"short": "PS-CA Family History Section",
"definition": "The family history section contains a description of the patient's family history.",
"comment": "This is a new section being introduced by the PS-CA specification at the request of jurisdictions.",
"max": "1"
},
{
"id": "Composition.section:sectionFamilyHistory.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
]
},
{
"id": "Composition.section:sectionFamilyHistory.title",
"path": "Composition.section.title",
"min": 1,
"mustSupport": true
},
{
"id": "Composition.section:sectionFamilyHistory.code",
"path": "Composition.section.code",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "10157-6"
}
]
},
"mustSupport": true
},
{
"id": "Composition.section:sectionFamilyHistory.entry",
"path": "Composition.section.entry",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"rules": "open"
},
"short": "Narrative description of the patient's family history.",
"mustSupport": true
},
{
"id": "Composition.section:sectionFamilyHistory.entry:FamilyMemberHistory",
"path": "Composition.section.entry",
"sliceName": "FamilyMemberHistory",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/familymemberhistory-ca-ps"
]
}
],
"mustSupport": true
},
{
"id": "Composition.section:sectionFamilyHistory.section",
"path": "Composition.section.section",
"max": "0"
},
{
"id": "Composition.section:sectionPatientStory",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Section"
}
],
"path": "Composition.section",
"sliceName": "sectionPatientStory",
"short": "PS-CA Patient Story Section",
"definition": "The section contains narrative text along with optional resources that express what matters to a patient. This may include needs, strengths, values, concerns and preferences to others providing support and care. The patient’s story, provided here, may be told by the patient or by a proxy.",
"comment": "This is a new section being introduced by the PS-CA specification at the request of jurisdictions. While the Patient Story section is relatively unconstrained at this time, information that is better suited to another section should not be included in the Patient Story. For example, DNR orders should be placed in the Advanced Directives section.",
"min": 0,
"max": "1"
},
{
"id": "Composition.section:sectionPatientStory.extension:section-note",
"path": "Composition.section.extension",
"sliceName": "section-note",
"short": "Additional notes that apply to the section (but not to specific resource).",
"definition": "Additional notes that apply to the section (but not to specific resource).",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/note"
]
}
]
},
{
"id": "Composition.section:sectionPatientStory.title",
"path": "Composition.section.title",
"min": 1,
"mustSupport": true
},
{
"id": "Composition.section:sectionPatientStory.code",
"path": "Composition.section.code",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "81338-6"
}
]
},
"mustSupport": true
}
]
}
}

Terminology bindings (Differential)

Terminology bindings (Snapshot)

PathConformanceValueSet
Composition.languagepreferredhttp://hl7.org/fhir/ValueSet/languages
Composition.statusrequiredhttp://hl7.org/fhir/ValueSet/composition-status|4.0.1
Composition.typepreferredhttp://hl7.org/fhir/ValueSet/doc-typecodes
Composition.categoryexamplehttp://hl7.org/fhir/ValueSet/document-classcodes
Composition.subject.typeextensiblehttp://hl7.org/fhir/ValueSet/resource-types
Composition.confidentialityrequiredhttp://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26
Composition.attester.moderequiredhttp://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1
Composition.relatesTo.coderequiredhttp://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1
Composition.event.codeexamplehttp://terminology.hl7.org/ValueSet/v3-ActCode
Composition.event:careProvisioningEvent.codeexamplehttp://terminology.hl7.org/ValueSet/v3-ActCode
Composition.section.codeexamplehttp://hl7.org/fhir/ValueSet/doc-section-codes
Composition.section.moderequiredhttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
Composition.section.orderedBypreferredhttp://hl7.org/fhir/ValueSet/list-order
Composition.section.emptyReasonpreferredhttp://hl7.org/fhir/ValueSet/list-empty-reason
Composition.section:sectionMedications.codeexamplehttp://hl7.org/fhir/ValueSet/doc-section-codes
Composition.section:sectionMedications.moderequiredhttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
Composition.section:sectionMedications.orderedBypreferredhttp://hl7.org/fhir/ValueSet/list-order
Composition.section:sectionMedications.emptyReasonpreferredhttp://hl7.org/fhir/ValueSet/list-empty-reason
Composition.section:sectionAllergies.codeexamplehttp://hl7.org/fhir/ValueSet/doc-section-codes
Composition.section:sectionAllergies.moderequiredhttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
Composition.section:sectionAllergies.orderedBypreferredhttp://hl7.org/fhir/ValueSet/list-order
Composition.section:sectionAllergies.emptyReasonpreferredhttp://hl7.org/fhir/ValueSet/list-empty-reason
Composition.section:sectionProblems.codeexamplehttp://hl7.org/fhir/ValueSet/doc-section-codes
Composition.section:sectionProblems.moderequiredhttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
Composition.section:sectionProblems.orderedBypreferredhttp://hl7.org/fhir/ValueSet/list-order
Composition.section:sectionProblems.emptyReasonpreferredhttp://hl7.org/fhir/ValueSet/list-empty-reason
Composition.section:sectionProceduresHx.codeexamplehttp://hl7.org/fhir/ValueSet/doc-section-codes
Composition.section:sectionProceduresHx.moderequiredhttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
Composition.section:sectionProceduresHx.orderedBypreferredhttp://hl7.org/fhir/ValueSet/list-order
Composition.section:sectionProceduresHx.emptyReasonpreferredhttp://hl7.org/fhir/ValueSet/list-empty-reason
Composition.section:sectionImmunizations.codeexamplehttp://hl7.org/fhir/ValueSet/doc-section-codes
Composition.section:sectionImmunizations.moderequiredhttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
Composition.section:sectionImmunizations.orderedBypreferredhttp://hl7.org/fhir/ValueSet/list-order
Composition.section:sectionImmunizations.emptyReasonpreferredhttp://hl7.org/fhir/ValueSet/list-empty-reason
Composition.section:sectionMedicalDevices.codeexamplehttp://hl7.org/fhir/ValueSet/doc-section-codes
Composition.section:sectionMedicalDevices.moderequiredhttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
Composition.section:sectionMedicalDevices.orderedBypreferredhttp://hl7.org/fhir/ValueSet/list-order
Composition.section:sectionMedicalDevices.emptyReasonpreferredhttp://hl7.org/fhir/ValueSet/list-empty-reason
Composition.section:sectionResults.codeexamplehttp://hl7.org/fhir/ValueSet/doc-section-codes
Composition.section:sectionResults.moderequiredhttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
Composition.section:sectionResults.orderedBypreferredhttp://hl7.org/fhir/ValueSet/list-order
Composition.section:sectionResults.emptyReasonpreferredhttp://hl7.org/fhir/ValueSet/list-empty-reason
Composition.section:sectionVitalSigns.codeexamplehttp://hl7.org/fhir/ValueSet/doc-section-codes
Composition.section:sectionVitalSigns.moderequiredhttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
Composition.section:sectionVitalSigns.orderedBypreferredhttp://hl7.org/fhir/ValueSet/list-order
Composition.section:sectionVitalSigns.emptyReasonpreferredhttp://hl7.org/fhir/ValueSet/list-empty-reason
Composition.section:sectionPastIllnessHx.codeexamplehttp://hl7.org/fhir/ValueSet/doc-section-codes
Composition.section:sectionPastIllnessHx.moderequiredhttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
Composition.section:sectionPastIllnessHx.orderedBypreferredhttp://hl7.org/fhir/ValueSet/list-order
Composition.section:sectionPastIllnessHx.emptyReasonpreferredhttp://hl7.org/fhir/ValueSet/list-empty-reason
Composition.section:sectionFunctionalStatus.codeexamplehttp://hl7.org/fhir/ValueSet/doc-section-codes
Composition.section:sectionFunctionalStatus.moderequiredhttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
Composition.section:sectionFunctionalStatus.orderedBypreferredhttp://hl7.org/fhir/ValueSet/list-order
Composition.section:sectionFunctionalStatus.emptyReasonpreferredhttp://hl7.org/fhir/ValueSet/list-empty-reason
Composition.section:sectionPlanOfCare.codeexamplehttp://hl7.org/fhir/ValueSet/doc-section-codes
Composition.section:sectionPlanOfCare.moderequiredhttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
Composition.section:sectionPlanOfCare.orderedBypreferredhttp://hl7.org/fhir/ValueSet/list-order
Composition.section:sectionPlanOfCare.emptyReasonpreferredhttp://hl7.org/fhir/ValueSet/list-empty-reason
Composition.section:sectionSocialHistory.codeexamplehttp://hl7.org/fhir/ValueSet/doc-section-codes
Composition.section:sectionSocialHistory.moderequiredhttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
Composition.section:sectionSocialHistory.orderedBypreferredhttp://hl7.org/fhir/ValueSet/list-order
Composition.section:sectionSocialHistory.emptyReasonpreferredhttp://hl7.org/fhir/ValueSet/list-empty-reason
Composition.section:sectionPregnancyHx.codeexamplehttp://hl7.org/fhir/ValueSet/doc-section-codes
Composition.section:sectionPregnancyHx.moderequiredhttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
Composition.section:sectionPregnancyHx.orderedBypreferredhttp://hl7.org/fhir/ValueSet/list-order
Composition.section:sectionPregnancyHx.emptyReasonpreferredhttp://hl7.org/fhir/ValueSet/list-empty-reason
Composition.section:sectionAdvanceDirectives.codeexamplehttp://hl7.org/fhir/ValueSet/doc-section-codes
Composition.section:sectionAdvanceDirectives.moderequiredhttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
Composition.section:sectionAdvanceDirectives.orderedBypreferredhttp://hl7.org/fhir/ValueSet/list-order
Composition.section:sectionAdvanceDirectives.emptyReasonpreferredhttp://hl7.org/fhir/ValueSet/list-empty-reason
Composition.section:sectionFamilyHistory.codeexamplehttp://hl7.org/fhir/ValueSet/doc-section-codes
Composition.section:sectionFamilyHistory.moderequiredhttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
Composition.section:sectionFamilyHistory.orderedBypreferredhttp://hl7.org/fhir/ValueSet/list-order
Composition.section:sectionFamilyHistory.emptyReasonpreferredhttp://hl7.org/fhir/ValueSet/list-empty-reason
Composition.section:sectionPatientStory.codeexamplehttp://hl7.org/fhir/ValueSet/doc-section-codes
Composition.section:sectionPatientStory.moderequiredhttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
Composition.section:sectionPatientStory.orderedBypreferredhttp://hl7.org/fhir/ValueSet/list-order
Composition.section:sectionPatientStory.emptyReasonpreferredhttp://hl7.org/fhir/ValueSet/list-empty-reason

Constraints

PathIdGradeDetailsExpression
Composition.section:sectionMedications, Composition.section:sectionAllergies, Composition.section:sectionProblemsips-comp-1, ips-comp-1, ips-comp-1error, error, errorEither section.entry or emptyReason are present, Either section.entry or emptyReason are present, Either section.entry or emptyReason are present(entry.reference.exists() or emptyReason.exists()), (entry.reference.exists() or emptyReason.exists()), (entry.reference.exists() or emptyReason.exists())

Obligations

Key Differences between the IPS-UV and PS-CA

Composition:

  • Across Composition: Removed redundant data type profiling on fixed/patterned codeable concepts, modified references to point to equivalent PS-CA profiles
  • Composition.event:careProvisioningEvent: Relaxed Must Support flag on the CareProvisioningEvent slice due to the scope of the PS-CA needing to support summaries that are generated outside a direct care event (e.g., including summaries that are machine-generated/on-demand). This will continue to be advocated for resolution at the IPS level
  • Composition.event:careProvisioningEvent.code element has a cardinality of [1, 1] in IPS-UV and [1, *] in PS-CA.
  • Composition.attester - Relaxed Must Support flag on the element. This decision in this release reflects the understanding of the current variability in workflows among Canadian Jurisdictional implementers, some of whom may not have the capability to populate the attester field at all. Further assessment will be completed against requirements and use cases for future versions.
  • Composition.author, Composition.attester, Composition.custodian - Modified references to point towards Canadian Baseline profiles and the Patient (PS-CA) profile since the IPS-UV currently only offers profiles that are scoped to diagnostic result authoring practitioners, organizations, etc.
    • Further investigation into whether additional elements/PS-CA profiles are needed (beyond the CA Baseline constraints) to support the use of these elements.

Note: Additionally, the use of CA Baseline Practitioner, PractitionerRole, Organization profiles will be superseded by the CA Core profiles (or profiles that impose the CA Core) in furture releases but the current usage of CA Baseline profiles will be maintained until a further stabilized CA Core profile (or further Patient Summary requirements) exist.

Note: Since the previous release of this specification, the modelling in IPS-UV that prohibited the use of section.emptyReason has been removed. See note above.

Composition Sections

  • In all Composition sections, code elements are marked as MS in PS-CA, but not in IPS-UV.

Composition.sectionProceduresHx + Composition.sectionImmunizations + Composition.sectionResults + Composition.sectionMedicalDevices:

  • Removed Must Support flag from these sections according to principles found in

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    • IPS-UV considers this a Must Support section. This constraint has been relaxed in the PS-CA to not put undue conformance expectations on jurisdictions who will not be including this domain/section in their initial implementation of patient summaries
    • Participating jurisdictions are expected to be able to receive this section in a patient summary (e.g., from another jurisdiction) without flagging an error
    • Vendors should anticipate that the Must Support flag may be re-evaluated for application in future releases
    • Additionally, vendors should expect that some jurisdictions may further constrain support of this section within the context of their own jurisdictional content
  • Note: Implementers are not expected to demonstrate support for these sections in v2.1.0 DFT, but the flags on the child elements have been maintained to ensure that if an implementer does produce these sections, they follow the expected patterning that is outlined in the IPS-UV and future PS-CA releases. See

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    .

  • Note: In earlier releases, IPS-UV has removed the Must Support flag on the following sections: Vital signs, PastIllnessHx, FunctionalStatus, PlanOfCare, Social History, PregnancyHx, AdvanceDirectives - bringing PS-CA into futher alignment with IPS-UV

Composition.sectionSocialHistory+ Composition.sectionFamilyMemberHistory:

  • Added FamilyMemberHistory section to meet the needs of jurisidctions wanting to pilot FamilyMemberHistory profile as part of their patient summary initiative
  • Expanded the sectionSocialHistory by including a new profile in addition to the Tobacco Use & Alcohol Use profiles to enable a more generalized social history profile to support implementers piloting a broader set of social history observations (not expected to be housed under the structured alcohol user and tobacco use profiles), and to house coded and non-coded lifestyle risk factors (e.g., amount of exercise, etc.)

Composition.sectionVitalSigns + Composition.sectionPastIllnessHx + Composition.sectionFunctionalStatus + Composition.sectionPlanOfCare + Composition.sectionSocialHistory + Composition.sectionPregnancyHx + Composition.sectionAdvanceDirectives + Composition.sectionFamilyHistory:

  • In these sections, title and entry elements are not MS in IPS-UV but are MS in PS-CA. Additionally, entry slices such as entry:pastProblem, entry:disability, entry:functionalAssessment, entry:pregnancyStatus, entry:pregnancyOutcomeSummary, entry:advanceDirectivesConsent and entry:FamilyMemberHistory are not MS in IPS-UV but are MS in PS-CA.

Composition.sectionAlerts:

  • This section has been added to ISO 27269 and IPS 2.0.0-ballot, but has not yet been introduced into PS-CA.

Composition.sectionVitalSigns:

  • The MS on component is only applicable to Blood Pressure. HL7 International has accepted the request to relax this MustSupport on the base Vital Signs profiles and keep it only for Blood Pressure. This will apply for future versions of these profiles since the PS-CA references FHIR R4.

Composition.sectionPatientStory:

  • The section contains narrative text along with optional resources that express what matters to a patient. This may include needs, strengths, values, concerns and preferences to others providing support and care. Information in this section may include:

    • My wellness and date
    • What are the most important things that I want to be known
    • Date of important elements
    • Important content to me
    • Important people to me

Any resource type may be used to support narrative.

IG © based on FHIR R4 | Package package:ca.infoway.io.psca@2.1.0-DFT
HL7® and FHIR® are the registered trademarks of Health Level Seven International