<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. 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." /> <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" /> <differential> <element id="Composition"> <path value="Composition" /> <short value="Canadian Patient Summary composition" /> <definition value="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." /> </element> <element id="Composition.text"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.text" /> <comment value="PS-CA is following IPS guidance regarding text and section.text. It is recommended that documents do not duplicate the content in Composition.section.text with content in Composition.text." /> <mustSupport value="true" /> </element> <element id="Composition.identifier"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.identifier" /> <mustSupport value="true" /> </element> <element id="Composition.status"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.status" /> <mustSupport value="true" /> </element> <element id="Composition.type"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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")" /> <patternCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="60591-5" /> </coding> </patternCodeableConcept> <mustSupport value="true" /> </element> <element id="Composition.subject"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.subject" /> <definition value="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." /> <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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.date" /> <mustSupport value="true" /> </element> <element id="Composition.author"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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. 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." /> <type> <code value="Reference" /> <targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/practitioner-ca-ps" /> <targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/practitionerrole-ca-ps" /> <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://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/organization-ca-ps" /> </type> <mustSupport value="true" /> </element> <element id="Composition.title"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.title" /> <short value="CA Patient Summary" /> <definition value="Official human-readable label for the composition. For this document should be "CA Patient Summary" or any equivalent translation" /> <mustSupport value="true" /> </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. 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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/practitioner-ca-ps" /> <targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/practitionerrole-ca-ps" /> <targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/organization-ca-ps" /> </type> <mustSupport value="true" /> </element> <element id="Composition.custodian"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.custodian" /> <type> <code value="Reference" /> <targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/organization-ca-ps" /> </type> <mustSupport value="true" /> </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." /> <min value="0" /> <max value="1" /> </element> <element id="Composition.event:careProvisioningEvent.code"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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="3" /> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.text" /> <comment value="PS-CA is following IPS guidance regarding text and section.text. It is recommended 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:sectionMedications"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Section" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </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: - 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." /> <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)" /> <source value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps" /> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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. Medication Summary" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:sectionMedications.code"> <path value="Composition.section.code" /> <patternCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="10160-0" /> </coding> </patternCodeableConcept> </element> <element id="Composition.section:sectionMedications.entry"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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." /> <min value="0" /> <max value="*" /> <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." /> <min value="0" /> <max value="*" /> <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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.emptyReason" /> <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> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </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. 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." /> <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)" /> <source value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps" /> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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" /> <patternCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="48765-2" /> </coding> </patternCodeableConcept> </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. At 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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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." /> <min value="0" /> <max value="*" /> <type> <code value="Reference" /> <targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/allergyintolerance-ca-ps" /> </type> <mustSupport value="true" /> </element> <element id="Composition.section:sectionAllergies.emptyReason"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.emptyReason" /> <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> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </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)" /> <source value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/composition-ca-ps" /> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:sectionProblems.code"> <path value="Composition.section.code" /> <patternCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="11450-4" /> </coding> </patternCodeableConcept> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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." /> <min value="0" /> <max value="*" /> <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:sectionProblems.emptyReason"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.emptyReason" /> <mustSupport value="true" /> </element> <element id="Composition.section:sectionProblems.section"> <path value="Composition.section.section" /> <max value="0" /> </element> <element id="Composition.section:sectionProceduresHx"> <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. 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" /> <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" /> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:sectionProceduresHx.code"> <path value="Composition.section.code" /> <patternCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="47519-4" /> </coding> </patternCodeableConcept> </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. 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." /> <mustSupport value="true" /> </element> <element id="Composition.section:sectionProceduresHx.entry:procedure"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.entry" /> <sliceName value="procedure" /> <min value="0" /> <max value="*" /> <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"> <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. 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." /> <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" /> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:sectionImmunizations.code"> <path value="Composition.section.code" /> <patternCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="11369-6" /> </coding> </patternCodeableConcept> </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. 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." /> <mustSupport value="true" /> </element> <element id="Composition.section:sectionImmunizations.entry:immunization"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.entry" /> <sliceName value="immunization" /> <min value="0" /> <max value="*" /> <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"> <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" /> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:sectionMedicalDevices.code"> <path value="Composition.section.code" /> <patternCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="46264-8" /> </coding> </patternCodeableConcept> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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." /> <min value="0" /> <max value="*" /> <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" /> <min value="0" /> <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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:sectionResults.code"> <path value="Composition.section.code" /> <patternCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="30954-2" /> </coding> </patternCodeableConcept> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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." /> <min value="0" /> <max value="*" /> <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" /> <min value="0" /> <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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:sectionVitalSigns.code"> <path value="Composition.section.code" /> <patternCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="8716-3" /> </coding> </patternCodeableConcept> </element> <element id="Composition.section:sectionVitalSigns.entry"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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" /> <min value="0" /> <max value="*" /> <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" /> <min value="0" /> <max value="*" /> <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" /> <min value="0" /> <max value="*" /> <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" /> <min value="0" /> <max value="*" /> <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" /> <min value="0" /> <max value="*" /> <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" /> <min value="0" /> <max value="*" /> <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" /> <min value="0" /> <max value="*" /> <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" /> <min value="0" /> <max value="*" /> <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" /> <min value="0" /> <max value="*" /> <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" /> <min value="0" /> <max value="*" /> <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"> <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" /> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:sectionPastIllnessHx.code"> <path value="Composition.section.code" /> <patternCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="11348-0" /> </coding> </patternCodeableConcept> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.entry" /> <sliceName value="pastProblem" /> <min value="0" /> <max value="*" /> <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"> <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. Profiles 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" /> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:sectionFunctionalStatus.code"> <path value="Composition.section.code" /> <patternCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="47420-5" /> </coding> </patternCodeableConcept> </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. Profiles 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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.entry" /> <sliceName value="disability" /> <min value="0" /> <max value="*" /> <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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.entry" /> <sliceName value="functionalAssessment" /> <min value="0" /> <max value="*" /> <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"> <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" /> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:sectionPlanOfCare.code"> <path value="Composition.section.code" /> <patternCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="18776-5" /> </coding> </patternCodeableConcept> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.entry" /> <sliceName value="carePlan" /> <min value="0" /> <max value="*" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" /> </type> <mustSupport value="true" /> </element> <element id="Composition.section:sectionPlanOfCare.entry:documentReference"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.entry" /> <sliceName value="documentReference" /> <min value="0" /> <max value="*" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference" /> </type> <mustSupport value="true" /> </element> <element id="Composition.section:sectionPlanOfCare.entry:immunizationRecommendation"> <path value="Composition.section.entry" /> <sliceName value="immunizationRecommendation" /> <min value="0" /> <max value="*" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation" /> </type> </element> <element id="Composition.section:sectionPlanOfCare.section"> <path value="Composition.section.section" /> <max value="0" /> </element> <element id="Composition.section:sectionSocialHistory"> <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" /> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:sectionSocialHistory.code"> <path value="Composition.section.code" /> <patternCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="29762-2" /> </coding> </patternCodeableConcept> </element> <element id="Composition.section:sectionSocialHistory.entry"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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" /> <min value="0" /> <max value="*" /> <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" /> <min value="0" /> <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" /> <min value="0" /> <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"> <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. It 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" /> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:sectionPregnancyHx.code"> <path value="Composition.section.code" /> <patternCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="10162-6" /> </coding> </patternCodeableConcept> </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. It may contain addition summarizing information about the outcome of earlier pregnancies." /> <mustSupport value="true" /> </element> <element id="Composition.section:sectionPregnancyHx.entry:pregnancyStatus"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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." /> <min value="0" /> <max value="*" /> <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:pregnancyOutcome"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.entry" /> <sliceName value="pregnancyOutcome" /> <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="*" /> <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"> <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" /> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:sectionAdvanceDirectives.code"> <path value="Composition.section.code" /> <patternCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="42348-3" /> </coding> </patternCodeableConcept> </element> <element id="Composition.section:sectionAdvanceDirectives.entry"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <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" /> <min value="0" /> <max value="*" /> <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" /> <min value="0" /> <max value="*" /> <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"> <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" /> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:sectionFamilyHistory.code"> <path value="Composition.section.code" /> <patternCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="10157-6" /> </coding> </patternCodeableConcept> </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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.entry" /> <sliceName value="FamilyMemberHistory" /> <min value="0" /> <max value="*" /> <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"> <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"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:sectionPatientStory.code"> <path value="Composition.section.code" /> <patternCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="81338-6" /> </coding> </patternCodeableConcept> </element> </differential> </StructureDefinition>