{
  "resourceType": "StructureDefinition",
  "id": "profile-discharge-summary",
  "url": "http://ontariohealth.ca/fhir/ocre/StructureDefinition/profile-discharge-summary",
  "version": "1.0.0-Ballot",
  "name": "DischargeSummaryOCRE",
  "title": "Experimental OCRE Discharge Summary",
  "status": "active",
  "description": "The Discharge Summary is a document which synopsizes a patient's admission to a hospital, LTPAC provider, or other setting. It provides information for the continuation of care following discharge. The Joint Commission requires the following information to be included in the Discharge Summary (http://www.jointcommission.org/):\n\n  The reason for hospitalization (the admission) \n\n  The procedures performed, as applicable\n\n  The care, treatment, and services provided\n\n  The patients condition and disposition at discharge\n\n  Information provided to the patient and family\n\n  Provisions for follow-up care\n\nThe best practice for a Discharge Summary is to include the discharge disposition in the display of the header.",
  "fhirVersion": "4.0.1",
  "kind": "resource",
  "abstract": false,
  "type": "Composition",
  "baseDefinition": "http://ontariohealth.ca/fhir/ocre/StructureDefinition/profile-header",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Composition.type",
        "path": "Composition.type",
        "label": "Discharge Summary",
        "short": "Discharge Summary",
        "binding": {
          "strength": "required",
          "valueSet": "http://ontariohealth.ca/fhir/ocre/ValueSet/document-type-discharge"
        }
      },
      {
        "id": "Composition.section",
        "path": "Composition.section",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "code"
            }
          ],
          "rules": "open"
        },
        "min": 3
      },
      {
        "id": "Composition.section:allergies_and_intolerances_section",
        "path": "Composition.section",
        "sliceName": "allergies_and_intolerances_section",
        "label": "Allergies and Intolerances Section",
        "short": "Allergies and Intolerances Section",
        "comment": "Allergies and Intolerances Section",
        "min": 1,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Composition.section:allergies_and_intolerances_section.title",
        "path": "Composition.section.title",
        "short": "title",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:allergies_and_intolerances_section.code",
        "path": "Composition.section.code",
        "label": "Allergies and adverse reactions",
        "short": "Allergies and adverse reactions",
        "min": 1,
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "48765-2",
              "system": "http://loinc.org"
            }
          ]
        },
        "mustSupport": true
      },
      {
        "id": "Composition.section:allergies_and_intolerances_section.text",
        "path": "Composition.section.text",
        "short": "text",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:allergies_and_intolerances_section.entry",
        "path": "Composition.section.entry",
        "slicing": {
          "discriminator": [
            {
              "type": "profile",
              "path": "resolve()"
            }
          ],
          "rules": "open"
        },
        "short": "entry"
      },
      {
        "id": "Composition.section:allergies_and_intolerances_section.entry:allergy_entry",
        "path": "Composition.section.entry",
        "sliceName": "allergy_entry",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://ontariohealth.ca/fhir/ehr/StructureDefinition/profile-allergyIntolerance"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Composition.section:hospital_course_section",
        "path": "Composition.section",
        "sliceName": "hospital_course_section",
        "label": "Hospital Course Section",
        "short": "Hospital Course Section",
        "min": 1,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Composition.section:hospital_course_section.title",
        "path": "Composition.section.title",
        "short": "title",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:hospital_course_section.code",
        "path": "Composition.section.code",
        "short": "code",
        "min": 1,
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "8648-8",
              "system": "http://loinc.org"
            }
          ]
        },
        "mustSupport": true
      },
      {
        "id": "Composition.section:hospital_course_section.text",
        "path": "Composition.section.text",
        "short": "This section contains only human readable content",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:discharge_diagnosis_section",
        "path": "Composition.section",
        "sliceName": "discharge_diagnosis_section",
        "label": "Discharge Diagnosis Section",
        "short": "Discharge Diagnosis Section",
        "min": 1,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Composition.section:discharge_diagnosis_section.title",
        "path": "Composition.section.title",
        "short": "title",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:discharge_diagnosis_section.code",
        "path": "Composition.section.code",
        "label": "Hospital discharge diagnosis",
        "short": "Hospital discharge diagnosis",
        "min": 1,
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "11535-2",
              "system": "http://loinc.org"
            }
          ]
        },
        "mustSupport": true
      },
      {
        "id": "Composition.section:discharge_diagnosis_section.text",
        "path": "Composition.section.text",
        "short": "text",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:discharge_diagnosis_section.entry",
        "path": "Composition.section.entry",
        "slicing": {
          "discriminator": [
            {
              "type": "profile",
              "path": "resolve()"
            }
          ],
          "rules": "open"
        },
        "short": "entry"
      },
      {
        "id": "Composition.section:discharge_diagnosis_section.entry:discharge_diagnosis_entry",
        "path": "Composition.section.entry",
        "sliceName": "discharge_diagnosis_entry",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://ontariohealth.ca/fhir/ehr/StructureDefinition/profile-condition"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Composition.section:plan_of_treatment_section",
        "path": "Composition.section",
        "sliceName": "plan_of_treatment_section",
        "label": "Plan of Treatment Section",
        "short": "Plan of Treatment Section",
        "comment": "Plan of Treatment Section",
        "min": 0,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Composition.section:plan_of_treatment_section.title",
        "path": "Composition.section.title",
        "short": "title",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:plan_of_treatment_section.code",
        "path": "Composition.section.code",
        "label": "Plan of treatment",
        "short": "Plan of treatment",
        "min": 1,
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "18776-5",
              "system": "http://loinc.org"
            }
          ]
        },
        "mustSupport": true
      },
      {
        "id": "Composition.section:plan_of_treatment_section.text",
        "path": "Composition.section.text",
        "short": "text",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:plan_of_treatment_section.entry",
        "path": "Composition.section.entry",
        "slicing": {
          "discriminator": [
            {
              "type": "profile",
              "path": "resolve()"
            }
          ],
          "rules": "open"
        },
        "short": "entry"
      },
      {
        "id": "Composition.section:plan_of_treatment_section.entry:sliceEntry",
        "path": "Composition.section.entry",
        "sliceName": "sliceEntry",
        "short": "This section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Goal",
              "http://hl7.org/fhir/StructureDefinition/MedicationRequest",
              "http://ontariohealth.ca/fhir/ehr/StructureDefinition/profile-encounter",
              "http://hl7.org/fhir/StructureDefinition/Communication",
              "http://hl7.org/fhir/StructureDefinition/Appointment",
              "http://hl7.org/fhir/StructureDefinition/CommunicationRequest",
              "http://hl7.org/fhir/StructureDefinition/DeviceRequest",
              "http://hl7.org/fhir/StructureDefinition/NutritionOrder",
              "http://hl7.org/fhir/StructureDefinition/Task",
              "http://ontariohealth.ca/fhir/ehr/StructureDefinition/profile-serviceRequest",
              "http://hl7.org/fhir/StructureDefinition/VisionPrescription",
              "http://hl7.org/fhir/StructureDefinition/RequestGroup"
            ]
          }
        ]
      },
      {
        "id": "Composition.section:discharge_medications_section",
        "path": "Composition.section",
        "sliceName": "discharge_medications_section",
        "label": "Discharge Medications Section",
        "short": "Discharge Medications Section",
        "min": 0,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Composition.section:discharge_medications_section.title",
        "path": "Composition.section.title",
        "short": "title",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:discharge_medications_section.code",
        "path": "Composition.section.code",
        "label": "Hospital discharge medications",
        "short": "Hospital discharge medications",
        "min": 1,
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "10183-2",
              "system": "http://loinc.org"
            }
          ]
        },
        "mustSupport": true
      },
      {
        "id": "Composition.section:discharge_medications_section.text",
        "path": "Composition.section.text",
        "short": "text",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:discharge_medications_section.entry",
        "path": "Composition.section.entry",
        "slicing": {
          "discriminator": [
            {
              "type": "profile",
              "path": "resolve()"
            }
          ],
          "rules": "open"
        },
        "short": "entry"
      },
      {
        "id": "Composition.section:discharge_medications_section.entry:discharge_medications_entry",
        "path": "Composition.section.entry",
        "sliceName": "discharge_medications_entry",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/MedicationStatement",
              "http://hl7.org/fhir/StructureDefinition/Medication",
              "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Composition.section:admission_diagnosis_section",
        "path": "Composition.section",
        "sliceName": "admission_diagnosis_section",
        "label": "Admission Diagnosis Section",
        "short": "Admission Diagnosis Section",
        "min": 0,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Composition.section:admission_diagnosis_section.title",
        "path": "Composition.section.title",
        "short": "title",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:admission_diagnosis_section.code",
        "path": "Composition.section.code",
        "label": "Hospital admission diagnosis",
        "short": "Hospital admission diagnosis",
        "min": 1,
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "46241-6",
              "system": "http://loinc.org"
            }
          ]
        },
        "mustSupport": true
      },
      {
        "id": "Composition.section:admission_diagnosis_section.text",
        "path": "Composition.section.text",
        "short": "text",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:admission_diagnosis_section.entry",
        "path": "Composition.section.entry",
        "slicing": {
          "discriminator": [
            {
              "type": "profile",
              "path": "resolve()"
            }
          ],
          "rules": "open"
        },
        "short": "entry"
      },
      {
        "id": "Composition.section:admission_diagnosis_section.entry:admission_diagnosis_entry",
        "path": "Composition.section.entry",
        "sliceName": "admission_diagnosis_entry",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://ontariohealth.ca/fhir/ehr/StructureDefinition/profile-condition"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Composition.section:admission_medications_section",
        "path": "Composition.section",
        "sliceName": "admission_medications_section",
        "label": "Admission Medications Section",
        "short": "Admission Medications Section",
        "min": 0,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Composition.section:admission_medications_section.title",
        "path": "Composition.section.title",
        "short": "title",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:admission_medications_section.code",
        "path": "Composition.section.code",
        "label": "Medications on admission",
        "short": "Medications on admission",
        "min": 1,
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "42346-7",
              "system": "http://loinc.org"
            }
          ]
        },
        "mustSupport": true
      },
      {
        "id": "Composition.section:admission_medications_section.text",
        "path": "Composition.section.text",
        "short": "text",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:admission_medications_section.entry",
        "path": "Composition.section.entry",
        "slicing": {
          "discriminator": [
            {
              "type": "profile",
              "path": "resolve()"
            }
          ],
          "rules": "open"
        },
        "short": "entry"
      },
      {
        "id": "Composition.section:admission_medications_section.entry:admission_medications_entry",
        "path": "Composition.section.entry",
        "sliceName": "admission_medications_entry",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/MedicationStatement",
              "http://hl7.org/fhir/StructureDefinition/Medication",
              "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Composition.section:chief_complaint_and_reason_for_visit_section",
        "path": "Composition.section",
        "sliceName": "chief_complaint_and_reason_for_visit_section",
        "label": "Chief Complaint and Reason for Visit Section",
        "short": "Chief Complaint and Reason for Visit Section. This section records the patient's chief complaint (the patient’s own description) and/or the reason for the patient's visit (the provider’s description of the reason for visit). Local policy determines whether the information is divided into two sections or recorded in one section serving both purposes.",
        "min": 0,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Composition.section:chief_complaint_and_reason_for_visit_section.title",
        "path": "Composition.section.title",
        "short": "title",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:chief_complaint_and_reason_for_visit_section.code",
        "path": "Composition.section.code",
        "short": "code",
        "min": 1,
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "46239-0",
              "system": "http://loinc.org"
            }
          ]
        },
        "mustSupport": true
      },
      {
        "id": "Composition.section:chief_complaint_and_reason_for_visit_section.text",
        "path": "Composition.section.text",
        "short": "This section contains only human readable content",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:chief_complaint_section",
        "path": "Composition.section",
        "sliceName": "chief_complaint_section",
        "label": "Chief Complaint Section",
        "short": "Chief Complaint Section",
        "min": 0,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Composition.section:chief_complaint_section.title",
        "path": "Composition.section.title",
        "short": "title",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:chief_complaint_section.code",
        "path": "Composition.section.code",
        "short": "code",
        "min": 1,
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "10154-3",
              "system": "http://loinc.org"
            }
          ]
        },
        "mustSupport": true
      },
      {
        "id": "Composition.section:chief_complaint_section.text",
        "path": "Composition.section.text",
        "short": "This section contains only human readable content",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:family_history_section",
        "path": "Composition.section",
        "sliceName": "family_history_section",
        "label": "Family History Section",
        "short": "Family History Section",
        "min": 0,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Composition.section:family_history_section.title",
        "path": "Composition.section.title",
        "short": "title",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:family_history_section.code",
        "path": "Composition.section.code",
        "short": "code",
        "min": 1,
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "10157-6",
              "system": "http://loinc.org"
            }
          ]
        },
        "mustSupport": true
      },
      {
        "id": "Composition.section:family_history_section.text",
        "path": "Composition.section.text",
        "short": "text",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:family_history_section.entry",
        "path": "Composition.section.entry",
        "slicing": {
          "discriminator": [
            {
              "type": "profile",
              "path": "resolve()"
            }
          ],
          "rules": "open"
        },
        "short": "entry"
      },
      {
        "id": "Composition.section:family_history_section.entry:family_history_entry",
        "path": "Composition.section.entry",
        "sliceName": "family_history_entry",
        "short": "This section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/FamilyMemberHistory"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Composition.section:functional_status_section",
        "path": "Composition.section",
        "sliceName": "functional_status_section",
        "label": "Functional Status Section",
        "short": "Functional Status Section",
        "min": 0,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Composition.section:functional_status_section.title",
        "path": "Composition.section.title",
        "short": "title",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:functional_status_section.code",
        "path": "Composition.section.code",
        "label": "Functional status",
        "short": "Functional status",
        "min": 1,
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "47420-5",
              "system": "http://loinc.org"
            }
          ]
        },
        "mustSupport": true
      },
      {
        "id": "Composition.section:functional_status_section.text",
        "path": "Composition.section.text",
        "short": "text",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:functional_status_section.entry",
        "path": "Composition.section.entry",
        "slicing": {
          "discriminator": [
            {
              "type": "profile",
              "path": "resolve()"
            }
          ],
          "rules": "open"
        },
        "short": "entry"
      },
      {
        "id": "Composition.section:functional_status_section.entry:functional_status_entry",
        "path": "Composition.section.entry",
        "sliceName": "functional_status_entry",
        "short": "This section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://ontariohealth.ca/fhir/ehr/StructureDefinition/profile-condition",
              "http://hl7.org/fhir/StructureDefinition/Observation",
              "http://hl7.org/fhir/StructureDefinition/ClinicalImpression"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Composition.section:history_of_present_illness_section",
        "path": "Composition.section",
        "sliceName": "history_of_present_illness_section",
        "label": "History of Present Illness Section",
        "short": "History of Present Illness Section",
        "min": 0,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Composition.section:history_of_present_illness_section.title",
        "path": "Composition.section.title",
        "short": "title",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:history_of_present_illness_section.code",
        "path": "Composition.section.code",
        "short": "code",
        "min": 1,
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "10164-2",
              "system": "http://loinc.org"
            }
          ]
        },
        "mustSupport": true
      },
      {
        "id": "Composition.section:history_of_present_illness_section.text",
        "path": "Composition.section.text",
        "short": "This section contains only human readable content",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:hospital_consultations_section",
        "path": "Composition.section",
        "sliceName": "hospital_consultations_section",
        "label": "Hospital Consultations Section",
        "short": "Hospital Consultations Section",
        "min": 0,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Composition.section:hospital_consultations_section.title",
        "path": "Composition.section.title",
        "short": "title",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Composition.section:hospital_consultations_section.code",
        "path": "Composition.section.code",
        "label": "Hospital consultations",
        "short": "Hospital consultations",
        "min": 1,
        "patternCodeableConcept": {
          "coding": [
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