<StructureDefinition xmlns="http://hl7.org/fhir">
  <url value="https://fhir.synapxe.sg/StructureDefinition/profile-medicalcertificate" />
  <name value="MedicalCertificate" />
  <status value="active" />
  <fhirVersion value="5.0.0" />
  <kind value="resource" />
  <abstract value="false" />
  <type value="DocumentReference" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DocumentReference" />
  <derivation value="constraint" />
  <snapshot>
    <element id="DocumentReference">
      <path value="DocumentReference" />
      <short value="A reference to a document" />
      <definition value="A reference to a document of any kind for any purpose. While the term “document” implies a more narrow focus, for this resource this &quot;document&quot; encompasses *any* serialized object with a mime-type, it includes formal patient-centric documents (CDA), clinical notes, scanned paper, non-patient specific documents like policy text, as well as a photo, video, or audio recording acquired or used in healthcare.  The DocumentReference resource provides metadata about the document so that the document can be discovered and managed.  The actual content may be inline base64 encoded data or provided by direct reference." />
      <comment value="Usually, this is used for documents other than those defined by FHIR." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DocumentReference" />
        <min value="0" />
        <max value="*" />
      </base>
      <constraint>
        <key value="dom-2" />
        <severity value="error" />
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
        <expression value="contained.contained.empty()" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="dom-4" />
        <severity value="error" />
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="dom-3" />
        <severity value="error" />
        <human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource" />
        <expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." />
        </extension>
        <key value="dom-6" />
        <severity value="warning" />
        <human value="A resource should have narrative for robust management" />
        <expression value="text.`div`.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="dom-5" />
        <severity value="error" />
        <human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
        <expression value="contained.meta.security.empty()" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="docRef-1" />
        <severity value="warning" />
        <human value="facilityType SHALL only be present if context is not an encounter" />
        <expression value="facilityType.empty() or context.where(resolve() is Encounter).empty()" />
        <source value="http://hl7.org/fhir/StructureDefinition/DocumentReference" />
      </constraint>
      <constraint>
        <key value="docRef-2" />
        <severity value="warning" />
        <human value="practiceSetting SHALL only be present if context is not present" />
        <expression value="practiceSetting.empty() or context.where(resolve() is Encounter).empty()" />
        <source value="http://hl7.org/fhir/StructureDefinition/DocumentReference" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Entity. Role, or Act" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Entity, Role, or Act" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="infrastructure.documents" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="when describing a Composition" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Document[classCode=&quot;DOC&quot; and moodCode=&quot;EVN&quot;]" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry" />
      </mapping>
      <mapping>
        <identity value="cda" />
        <map value="when describing a CDA" />
      </mapping>
    </element>
    <element id="DocumentReference.id">
      <path value="DocumentReference.id" />
      <short value="Logical id of this artifact" />
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
      <comment value="Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
    </element>
    <element id="DocumentReference.meta">
      <path value="DocumentReference.meta" />
      <short value="Metadata about the resource" />
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.meta" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Meta" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.implicitRules">
      <path value="DocumentReference.implicitRules" />
      <short value="A set of rules under which this content was created" />
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc." />
      <comment value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.implicitRules" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="true" />
      <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="DocumentReference.language">
      <path value="DocumentReference.language" />
      <short value="Language of the resource content" />
      <definition value="The base language in which the resource is written." />
      <comment value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.language" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language" />
        </extension>
        <strength value="required" />
        <description value="IETF language tag for a human language" />
        <valueSet value="http://hl7.org/fhir/ValueSet/all-languages|5.0.0" />
        <additional>
          <purpose value="starter" />
          <valueSet value="http://hl7.org/fhir/ValueSet/languages" />
        </additional>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="DocumentReference.text">
      <path value="DocumentReference.text" />
      <short value="Text summary of the resource, for human interpretation" />
      <definition value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
      <comment value="Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later." />
      <alias value="narrative" />
      <alias value="html" />
      <alias value="xhtml" />
      <alias value="display" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="DomainResource.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Narrative" />
      </type>
      <condition value="dom-6" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Act.text?" />
      </mapping>
    </element>
    <element id="DocumentReference.contained">
      <path value="DocumentReference.contained" />
      <short value="Contained, inline Resources" />
      <definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning." />
      <comment value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels." />
      <alias value="inline resources" />
      <alias value="anonymous resources" />
      <alias value="contained resources" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.contained" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Resource" />
      </type>
      <condition value="dom-2" />
      <condition value="dom-4" />
      <condition value="dom-3" />
      <condition value="dom-5" />
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Entity. Role, or Act" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.extension">
      <path value="DocumentReference.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.extension:lightDuty">
      <path value="DocumentReference.extension" />
      <sliceName value="lightDuty" />
      <short value="Light Duty Extension" />
      <definition value="Extension for capturing light duty information" />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="DomainResource.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.synapxe.sg/StructureDefinition/ext-lightDuty" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.modifierExtension">
      <path value="DocumentReference.modifierExtension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Extensions that cannot be ignored" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="true" />
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.identifier">
      <path value="DocumentReference.identifier" />
      <short value="An identifier intended for computation" />
      <definition value="An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers." />
      <comment value="The rules of the identifier.type  determine if a check digit is part of the ID value or sent separately, such as through the checkDigit extension." />
      <requirements value="Document identifiers usually assigned by the source of the document, or other business identifiers such as XDS DocumentEntry.uniqueId and DocumentEntry.entryUUID. These identifiers are specific to this instance of the document." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="DocumentReference.identifier" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Identifier" />
        <profile value="https://fhir.synapxe.sg/StructureDefinition/profile-identifier" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ident-1" />
        <severity value="warning" />
        <human value="Identifier with no value has limited utility.  If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason" />
        <expression value="value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Identifier" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="Identifier" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.identifier" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.identifier" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.identifier" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="TXA-12" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".id / .setId" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry.entryUUID, DocumentEntry.uniqueId" />
      </mapping>
      <mapping>
        <identity value="cda" />
        <map value="ClinicalDocument/id" />
      </mapping>
    </element>
    <element id="DocumentReference.identifier.id">
      <path value="DocumentReference.identifier.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <condition value="ele-1" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="DocumentReference.identifier.extension">
      <path value="DocumentReference.identifier.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.identifier.use">
      <path value="DocumentReference.identifier.use" />
      <short value="usual | official | temp | secondary | old (If known)" />
      <definition value="The purpose of this identifier." />
      <comment value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
      <requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Identifier.use" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one." />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueString value="Identifies the purpose for this identifier, if known ." />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierUse" />
        </extension>
        <strength value="required" />
        <description value="Identifies the purpose for this identifier, if known ." />
        <valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|5.0.0" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.code or implied by context" />
      </mapping>
    </element>
    <element id="DocumentReference.identifier.type">
      <path value="DocumentReference.identifier.type" />
      <short value="Description of identifier" />
      <definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
      <comment value="This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.   Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type." />
      <requirements value="Allows users to make use of identifiers when the identifier system is not known." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Identifier.type" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueString value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierType" />
        </extension>
        <strength value="extensible" />
        <description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
        <valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.5" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.code or implied by context" />
      </mapping>
    </element>
    <element id="DocumentReference.identifier.system">
      <path value="DocumentReference.identifier.system" />
      <short value="The namespace for the identifier value" />
      <definition value="Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique." />
      <comment value="Identifier.system is always case sensitive." />
      <requirements value="There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Identifier.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <fixedUri value="https://fhir.synapxe.sg/NamingSystem/mc-no" />
      <example>
        <label value="General" />
        <valueUri value="http://www.acme.com/identifiers/patient" />
      </example>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.4 / EI-2-4" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.root or Role.id.root" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./IdentifierType" />
      </mapping>
    </element>
    <element id="DocumentReference.identifier.value">
      <path value="DocumentReference.identifier.value" />
      <short value="The value that is unique" />
      <definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
      <comment value="If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [http://hl7.org/fhir/StructureDefinition/rendered-value](http://hl7.org/fhir/extensions/StructureDefinition-rendered-value.html)). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Identifier.value" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <example>
        <label value="General" />
        <valueString value="123456" />
      </example>
      <condition value="ident-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.1 / EI.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./Value" />
      </mapping>
    </element>
    <element id="DocumentReference.identifier.period">
      <path value="DocumentReference.identifier.period" />
      <short value="Time period when id is/was valid for use" />
      <definition value="Time period during which identifier is/was valid for use." />
      <comment value="A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. &quot;the patient was an inpatient of the hospital for this time range&quot;) or one value from the range applies (e.g. &quot;give to the patient between these two times&quot;).&#xA;&#xA;Period is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Identifier.period" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Period" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="per-1" />
        <severity value="error" />
        <human value="If present, start SHALL have a lower or equal value than end" />
        <expression value="start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() &lt;= end.highBoundary())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Period" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="DR" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="IVL&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;] or URG&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;]" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.7 + CX.8" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.effectiveTime or implied by context" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./StartDate and ./EndDate" />
      </mapping>
    </element>
    <element id="DocumentReference.identifier.assigner">
      <path value="DocumentReference.identifier.assigner" />
      <short value="Organization that issued id (may be just text)" />
      <definition value="Organization that issued/manages the identifier." />
      <comment value="The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Identifier.assigner" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.4 / (CX.4,CX.9,CX.10)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./IdentifierIssuingAuthority" />
      </mapping>
    </element>
    <element id="DocumentReference.version">
      <path value="DocumentReference.version" />
      <short value="An explicitly assigned identifer of a variation of the content in the DocumentReference" />
      <definition value="An explicitly assigned identifer of a variation of the content in the DocumentReference." />
      <comment value="While each resource, including the DocumentReference itself, has its own version identifier, this is a formal identifier for the logical version of the DocumentReference as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="DocumentReference.version" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.version" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.version" />
      </mapping>
    </element>
    <element id="DocumentReference.basedOn">
      <path value="DocumentReference.basedOn" />
      <short value="Procedure that caused this media to be created" />
      <definition value="A procedure that is fulfilled in whole or in part by the creation of this media." />
      <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
      <requirements value="Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon." />
      <alias value="fulfills" />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="DocumentReference.basedOn" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Appointment" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/AppointmentResponse" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Claim" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CommunicationRequest" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Contract" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CoverageEligibilityRequest" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceRequest" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/EnrollmentRequest" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/NutritionOrder" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RequestOrchestration" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/SupplyRequest" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/VisionPrescription" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=FLFS].target" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry.referenceIdList" />
      </mapping>
    </element>
    <element id="DocumentReference.status">
      <path value="DocumentReference.status" />
      <short value="current | superseded | entered-in-error" />
      <definition value="The status of this document reference." />
      <comment value="This is the status of the DocumentReference object, which might be independent from the docStatus element.&#xA;&#xA;This element is labeled as a modifier because the status contains the codes that mark the document or reference as not currently valid." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="DocumentReference.status" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="true" />
      <isModifierReason value="This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DocumentReferenceStatus" />
        </extension>
        <strength value="required" />
        <description value="The status of the document reference." />
        <valueSet value="http://hl7.org/fhir/ValueSet/document-reference-status|5.0.0" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.status" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.status" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="TXA-19" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="interim: .completionCode=&quot;IN&quot; &amp; ./statusCode[isNormalDatatype()]=&quot;active&quot;;  final: .completionCode=&quot;AU&quot; &amp;&amp;  ./statusCode[isNormalDatatype()]=&quot;complete&quot; and not(./inboundRelationship[typeCode=&quot;SUBJ&quot; and isNormalActRelationship()]/source[subsumesCode(&quot;ActClass#CACT&quot;) and moodCode=&quot;EVN&quot; and domainMember(&quot;ReviseDocument&quot;, code) and isNormalAct()]);  amended: .completionCode=&quot;AU&quot; &amp;&amp;  ./statusCode[isNormalDatatype()]=&quot;complete&quot; and ./inboundRelationship[typeCode=&quot;SUBJ&quot; and isNormalActRelationship()]/source[subsumesCode(&quot;ActClass#CACT&quot;) and moodCode=&quot;EVN&quot; and domainMember(&quot;ReviseDocument&quot;, code) and isNormalAct() and statusCode=&quot;completed&quot;];  withdrawn : .completionCode=NI &amp;&amp;  ./statusCode[isNormalDatatype()]=&quot;obsolete&quot;" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry.availabilityStatus" />
      </mapping>
    </element>
    <element id="DocumentReference.docStatus">
      <path value="DocumentReference.docStatus" />
      <short value="registered | partial | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | deprecated | unknown" />
      <definition value="The status of the underlying document." />
      <comment value="The document that is pointed to might be in various lifecycle states." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="DocumentReference.docStatus" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ReferredDocumentStatus" />
        </extension>
        <strength value="required" />
        <description value="Status of the underlying document." />
        <valueSet value="http://hl7.org/fhir/ValueSet/composition-status|5.0.0" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.status" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.status" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="TXA-17" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".statusCode" />
      </mapping>
    </element>
    <element id="DocumentReference.modality">
      <path value="DocumentReference.modality" />
      <short value="Imaging modality used" />
      <definition value="Imaging modality used. This may include both acquisition and non-acquisition modalities." />
      <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="DocumentReference.modality" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImagingModality" />
        </extension>
        <strength value="extensible" />
        <description value="Type of acquired data in the instance." />
        <valueSet value="http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_33.html" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.class" />
      </mapping>
    </element>
    <element id="DocumentReference.type">
      <path value="DocumentReference.type" />
      <short value="Type of medicate certificate" />
      <definition value="A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text." />
      <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="DocumentReference.type" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
        <profile value="https://fhir.synapxe.sg/StructureDefinition/profile-codeableconcept" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DocumentType" />
        </extension>
        <strength value="preferred" />
        <description value="Precise type of clinical document." />
        <valueSet value="http://hl7.org/fhir/ValueSet/doc-typecodes" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.code" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.what[x]" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.type" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="TXA-2" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./code" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry.typeCode" />
      </mapping>
      <mapping>
        <identity value="cda" />
        <map value="ClinicalDocument/code/@code &#xA;&#xA;The typeCode should be mapped from the ClinicalDocument/code element to a set of document type codes configured in the affinity domain. One suggested coding system to use for typeCode is LOINC, in which case the mapping step can be omitted." />
      </mapping>
    </element>
    <element id="DocumentReference.category">
      <path value="DocumentReference.category" />
      <short value="Categorization of document" />
      <definition value="A categorization for the type of document referenced - helps for indexing and searching. This may be implied by or derived from the code specified in the DocumentReference.type." />
      <comment value="Key metadata element describing the the category or classification of the document. This is a broader perspective that groups similar documents based on how they would be used. This is a primary key used in searching." />
      <alias value="class" />
      <alias value="classCode" />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="DocumentReference.category" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ReferencedItemCategory" />
        </extension>
        <strength value="example" />
        <description value="High-level kind of document at a macro level." />
        <valueSet value="http://hl7.org/fhir/ValueSet/referenced-item-category" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.what[x]" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.category" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=&quot;COMP].target[classCode=&quot;LIST&quot;, moodCode=&quot;EVN&quot;].code" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry.classCode" />
      </mapping>
      <mapping>
        <identity value="cda" />
        <map value="Derived from a mapping of /ClinicalDocument/code/@code to an Affinity Domain specified coded value to use and coding system. Affinity Domains are encouraged to use the appropriate value for Type of Service, based on the LOINC Type of Service (see Page 53 of the LOINC User's Manual). Must be consistent with /ClinicalDocument/code/@code" />
      </mapping>
    </element>
    <element id="DocumentReference.subject">
      <path value="DocumentReference.subject" />
      <short value="Who/what is the subject of the document" />
      <definition value="Who or what the document is about. The document can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of farm animals, or a set of patients that share a common exposure)." />
      <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="DocumentReference.subject" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.subject" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.subject[x]" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.subject" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="PID-3 (No standard way to define a Practitioner or Group subject in HL7 V2 MDM message)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=&quot;SBJ&quot;].role[typeCode=&quot;PAT&quot;]" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry.patientId" />
      </mapping>
      <mapping>
        <identity value="cda" />
        <map value="ClinicalDocument/recordTarget/" />
      </mapping>
    </element>
    <element id="DocumentReference.context">
      <path value="DocumentReference.context" />
      <short value="Context of the document content" />
      <definition value="Describes the clinical encounter or type of care that the document content is associated with." />
      <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="DocumentReference.context" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Appointment" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare" />
      </type>
      <condition value="docRef-1" />
      <condition value="docRef-2" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.encounter" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.context" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.encounter" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="unique(highest(./outboundRelationship[typeCode=&quot;SUBJ&quot; and isNormalActRelationship()], priorityNumber)/target[moodCode=&quot;EVN&quot; and classCode=(&quot;ENC&quot;, &quot;PCPR&quot;) and isNormalAct])" />
      </mapping>
    </element>
    <element id="DocumentReference.event">
      <path value="DocumentReference.event" />
      <short value="Main clinical acts documented" />
      <definition value="This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the type Code, such as a &quot;History and Physical Report&quot; in which the procedure being documented is necessarily a &quot;History and Physical&quot; act." />
      <comment value="An event can further specialize the act inherent in the type, such as  where it is simply &quot;Procedure Report&quot; and the procedure was a &quot;colonoscopy&quot;. If one or more event codes are included, they shall not conflict with the values inherent in the class or type elements as such a conflict would create an ambiguous situation." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="DocumentReference.event" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableReference" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DocumentEventType" />
        </extension>
        <strength value="example" />
        <description value="This list of codes represents the main clinical acts being documented." />
        <valueSet value="http://terminology.hl7.org/ValueSet/v3-ActCode" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.event.detail" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".code" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry.referenceIdList" />
      </mapping>
    </element>
    <element id="DocumentReference.bodySite">
      <path value="DocumentReference.bodySite" />
      <short value="Body part included" />
      <definition value="The anatomic structures included in the document." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="DocumentReference.bodySite" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableReference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/BodyStructure" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueString value="Codes describing anatomical locations. May include laterality." />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="BodySite" />
        </extension>
        <strength value="example" />
        <description value="SNOMED CT Body site concepts" />
        <valueSet value="http://hl7.org/fhir/ValueSet/body-site" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".targetSiteCode" />
      </mapping>
    </element>
    <element id="DocumentReference.facilityType">
      <path value="DocumentReference.facilityType" />
      <short value="Kind of facility where patient was seen" />
      <definition value="The kind of facility where the patient was seen." />
      <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="DocumentReference.facilityType" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="docRef-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DocumentC80FacilityType" />
        </extension>
        <strength value="example" />
        <description value="XDS Facility Type." />
        <valueSet value="http://hl7.org/fhir/ValueSet/c80-facilitycodes" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="usually from a mapping to a local ValueSet" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=&quot;LOC&quot;].role[classCode=&quot;DSDLOC&quot;].code" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry.healthcareFacilityTypeCode" />
      </mapping>
      <mapping>
        <identity value="cda" />
        <map value="usually a mapping to a local ValueSet. Must be consistent with /clinicalDocument/code" />
      </mapping>
    </element>
    <element id="DocumentReference.practiceSetting">
      <path value="DocumentReference.practiceSetting" />
      <short value="Additional details about where the content was created (e.g. clinical specialty)" />
      <definition value="This property may convey specifics about the practice setting where the content was created, often reflecting the clinical specialty." />
      <comment value="This element should be based on a coarse classification system for the class of specialty practice. Recommend the use of the classification system for Practice Setting, such as that described by the Subject Matter Domain in LOINC." />
      <requirements value="This is an important piece of metadata that providers often rely upon to quickly sort and/or filter out to find specific content." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="DocumentReference.practiceSetting" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="docRef-2" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DocumentC80PracticeSetting" />
        </extension>
        <strength value="example" />
        <description value="Additional details about where the content was created (e.g. clinical specialty)." />
        <valueSet value="http://hl7.org/fhir/ValueSet/c80-practice-codes" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="usually from a mapping to a local ValueSet" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=&quot;LOC&quot;].role[classCode=&quot;DSDLOC&quot;].code" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry.practiceSettingCode" />
      </mapping>
      <mapping>
        <identity value="cda" />
        <map value="usually from a mapping to a local ValueSet" />
      </mapping>
    </element>
    <element id="DocumentReference.period">
      <path value="DocumentReference.period" />
      <short value="Time of service that is being documented" />
      <definition value="The time period over which the service that is described by the document was provided." />
      <comment value="A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. &quot;the patient was an inpatient of the hospital for this time range&quot;) or one value from the range applies (e.g. &quot;give to the patient between these two times&quot;).&#xA;&#xA;Period is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="DocumentReference.period" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Period" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="per-1" />
        <severity value="error" />
        <human value="If present, start SHALL have a lower or equal value than end" />
        <expression value="start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() &lt;= end.highBoundary())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Period" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="DR" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="IVL&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;] or URG&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;]" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.event.period" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".effectiveTime" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry.serviceStartTime, DocumentEntry.serviceStopTime" />
      </mapping>
      <mapping>
        <identity value="cda" />
        <map value="ClinicalDocument/documentationOf/&#xA;serviceEvent/effectiveTime/low/&#xA;@value --&gt; ClinicalDocument/documentationOf/&#xA;serviceEvent/effectiveTime/high/&#xA;@value" />
      </mapping>
    </element>
    <element id="DocumentReference.period.id">
      <path value="DocumentReference.period.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <condition value="ele-1" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="DocumentReference.period.extension">
      <path value="DocumentReference.period.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.period.start">
      <path value="DocumentReference.period.start" />
      <short value="Starting time with inclusive boundary" />
      <definition value="The start of the period. The boundary is inclusive." />
      <comment value="If the low element is missing, the meaning is that the low boundary is not known." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Period.start" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <condition value="per-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="DR.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./low" />
      </mapping>
    </element>
    <element id="DocumentReference.period.end">
      <path value="DocumentReference.period.end" />
      <short value="End time with inclusive boundary, if not ongoing" />
      <definition value="The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time." />
      <comment value="The end value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Period.end" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <meaningWhenMissing value="If the end of the period is missing, it means that the period is ongoing" />
      <condition value="per-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="DR.2" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./high" />
      </mapping>
    </element>
    <element id="DocumentReference.date">
      <path value="DocumentReference.date" />
      <short value="When this document reference was created" />
      <definition value="When the document reference was created." />
      <comment value="Referencing/indexing time is used for tracking, organizing versions and searching." />
      <alias value="indexed" />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="DocumentReference.date" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="instant" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.occurrence[x]" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.recorded" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.date" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".availabilityTime[type=&quot;TS&quot;]" />
      </mapping>
    </element>
    <element id="DocumentReference.author">
      <path value="DocumentReference.author" />
      <short value="Who and/or what authored the document" />
      <definition value="Identifies who is responsible for adding the information to the document." />
      <comment value="Not necessarily who did the actual data entry (i.e. typist) or who was the source (informant)." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="DocumentReference.author" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="https://fhir.synapxe.sg/StructureDefinition/profile-practitioner" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.performer.actor" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.author" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="TXA-9 (No standard way to indicate a Device in HL7 V2 MDM message)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=&quot;AUT&quot;].role[classCode=&quot;ASSIGNED&quot;]" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry.author" />
      </mapping>
      <mapping>
        <identity value="cda" />
        <map value="ClinicalDocument/author" />
      </mapping>
    </element>
    <element id="DocumentReference.author.id">
      <path value="DocumentReference.author.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <condition value="ele-1" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="DocumentReference.author.extension">
      <path value="DocumentReference.author.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.author.reference">
      <path value="DocumentReference.author.reference" />
      <short value="Literal reference, Relative, internal or absolute URL" />
      <definition value="A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources." />
      <comment value="Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure &quot;[type]/[id]&quot; then it should be assumed that the reference is to a FHIR RESTful server." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Reference.reference" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ref-2" />
      <condition value="ref-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.author.type">
      <path value="DocumentReference.author.type" />
      <short value="Type the reference refers to (e.g. &quot;Patient&quot;) - must be a resource in resources" />
      <definition value="The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.&#xA;&#xA;The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. &quot;Patient&quot; is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources)." />
      <comment value="This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Reference.type" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <fixedUri value="Practitioner" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueString value="Aa resource (or, for logical models, the URI of the logical model)." />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="FHIRResourceTypeExt" />
        </extension>
        <strength value="extensible" />
        <description value="Aa resource (or, for logical models, the URI of the logical model)." />
        <valueSet value="http://hl7.org/fhir/ValueSet/resource-types" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.author.identifier">
      <path value="DocumentReference.author.identifier" />
      <short value="An identifier intended for computation" />
      <definition value="An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers." />
      <comment value="The rules of the identifier.type  determine if a check digit is part of the ID value or sent separately, such as through the checkDigit extension." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Reference.identifier" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Identifier" />
        <profile value="https://fhir.synapxe.sg/StructureDefinition/profile-identifier" />
      </type>
      <condition value="ref-2" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ident-1" />
        <severity value="warning" />
        <human value="Identifier with no value has limited utility.  If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason" />
        <expression value="value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Identifier" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="Identifier" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".identifier" />
      </mapping>
    </element>
    <element id="DocumentReference.author.identifier.id">
      <path value="DocumentReference.author.identifier.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <condition value="ele-1" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="DocumentReference.author.identifier.extension">
      <path value="DocumentReference.author.identifier.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.author.identifier.use">
      <path value="DocumentReference.author.identifier.use" />
      <short value="usual | official | temp | secondary | old (If known)" />
      <definition value="The purpose of this identifier." />
      <comment value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
      <requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Identifier.use" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one." />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueString value="Identifies the purpose for this identifier, if known ." />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierUse" />
        </extension>
        <strength value="required" />
        <description value="Identifies the purpose for this identifier, if known ." />
        <valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|5.0.0" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.code or implied by context" />
      </mapping>
    </element>
    <element id="DocumentReference.author.identifier.type">
      <path value="DocumentReference.author.identifier.type" />
      <short value="Description of identifier" />
      <definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
      <comment value="This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.   Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type." />
      <requirements value="Allows users to make use of identifiers when the identifier system is not known." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Identifier.type" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueString value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierType" />
        </extension>
        <strength value="extensible" />
        <description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
        <valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.5" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.code or implied by context" />
      </mapping>
    </element>
    <element id="DocumentReference.author.identifier.system">
      <path value="DocumentReference.author.identifier.system" />
      <short value="The namespace for the identifier value" />
      <definition value="Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique." />
      <comment value="Identifier.system is always case sensitive." />
      <requirements value="There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Identifier.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <fixedUri value="https://fhir.synapxe.sg/NamingSystem/mcr" />
      <example>
        <label value="General" />
        <valueUri value="http://www.acme.com/identifiers/patient" />
      </example>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.4 / EI-2-4" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.root or Role.id.root" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./IdentifierType" />
      </mapping>
    </element>
    <element id="DocumentReference.author.identifier.value">
      <path value="DocumentReference.author.identifier.value" />
      <short value="The value that is unique" />
      <definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
      <comment value="If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [http://hl7.org/fhir/StructureDefinition/rendered-value](http://hl7.org/fhir/extensions/StructureDefinition-rendered-value.html)). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Identifier.value" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <example>
        <label value="General" />
        <valueString value="123456" />
      </example>
      <condition value="ident-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.1 / EI.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./Value" />
      </mapping>
    </element>
    <element id="DocumentReference.author.identifier.period">
      <path value="DocumentReference.author.identifier.period" />
      <short value="Time period when id is/was valid for use" />
      <definition value="Time period during which identifier is/was valid for use." />
      <comment value="A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. &quot;the patient was an inpatient of the hospital for this time range&quot;) or one value from the range applies (e.g. &quot;give to the patient between these two times&quot;).&#xA;&#xA;Period is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Identifier.period" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Period" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="per-1" />
        <severity value="error" />
        <human value="If present, start SHALL have a lower or equal value than end" />
        <expression value="start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() &lt;= end.highBoundary())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Period" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="DR" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="IVL&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;] or URG&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;]" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.7 + CX.8" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.effectiveTime or implied by context" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./StartDate and ./EndDate" />
      </mapping>
    </element>
    <element id="DocumentReference.author.identifier.assigner">
      <path value="DocumentReference.author.identifier.assigner" />
      <short value="Organization that issued id (may be just text)" />
      <definition value="Organization that issued/manages the identifier." />
      <comment value="The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Identifier.assigner" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.4 / (CX.4,CX.9,CX.10)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./IdentifierIssuingAuthority" />
      </mapping>
    </element>
    <element id="DocumentReference.author.display">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true" />
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true" />
      </extension>
      <path value="DocumentReference.author.display" />
      <short value="Text alternative for the resource" />
      <definition value="Plain text narrative that identifies the resource in addition to the resource reference." />
      <comment value="This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Reference.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ref-2" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.attester">
      <path value="DocumentReference.attester" />
      <short value="Attests to accuracy of the document" />
      <definition value="A participant who has authenticated the accuracy of the document." />
      <comment value="Only list each attester once." />
      <requirements value="Identifies responsibility for the accuracy of the document content." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="DocumentReference.attester" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.performer.actor" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.attester" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=&quot;AUTHEN&quot;].role[classCode=&quot;ASSIGNED&quot;]" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry.legalAuthenticator" />
      </mapping>
      <mapping>
        <identity value="cda" />
        <map value=".authenticator/.legalAuthenticator" />
      </mapping>
    </element>
    <element id="DocumentReference.attester.id">
      <path value="DocumentReference.attester.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <condition value="ele-1" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="DocumentReference.attester.extension">
      <path value="DocumentReference.attester.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.attester.modifierExtension">
      <path value="DocumentReference.attester.modifierExtension" />
      <short value="Extensions that cannot be ignored even if unrecognized" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
      <alias value="extensions" />
      <alias value="user content" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="BackboneElement.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.attester.mode">
      <path value="DocumentReference.attester.mode" />
      <short value="personal | professional | legal | official" />
      <definition value="The type of attestation the authenticator offers." />
      <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
      <requirements value="Indicates the level of authority of the attestation." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="DocumentReference.attester.mode" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DocumentAttestationMode" />
        </extension>
        <strength value="preferred" />
        <description value="The way in which a person authenticated a document." />
        <valueSet value="http://hl7.org/fhir/ValueSet/composition-attestation-mode" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.attester.mode" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="unique(./modeCode)" />
      </mapping>
      <mapping>
        <identity value="cda" />
        <map value="implied by .authenticator/.legalAuthenticator" />
      </mapping>
    </element>
    <element id="DocumentReference.attester.time">
      <path value="DocumentReference.attester.time" />
      <short value="When the document was attested" />
      <definition value="When the document was attested by the party." />
      <comment value="UTC offset is allowed for dates and partial dates" />
      <requirements value="Identifies when the information in the document was deemed accurate.  (Things may have changed since then.)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="DocumentReference.attester.time" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.attester.time" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./time[type=&quot;TS&quot; and isNormalDatatype()]" />
      </mapping>
      <mapping>
        <identity value="cda" />
        <map value=".authenticator.time" />
      </mapping>
    </element>
    <element id="DocumentReference.attester.party">
      <path value="DocumentReference.attester.party" />
      <short value="Who attested the document" />
      <definition value="Who attested the document in the specified way." />
      <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
      <requirements value="Identifies who has taken on the responsibility for accuracy of the document content." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="DocumentReference.attester.party" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.witness" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.attester.party" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="TXA-10" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./role[classCode=&quot;ASSIGNED&quot; and isNormalRole]/player[determinerCode=&quot;INST&quot; and classCode=(&quot;DEV&quot;, &quot;PSN&quot;) and isNormalEntity()] or ./role[classCode=&quot;ASSIGNED&quot; and isNormalRole and not(player)]/scoper[determinerCode=&quot;INST&quot; and classCode=&quot;ORG&quot; and isNormalEntity()]" />
      </mapping>
      <mapping>
        <identity value="cda" />
        <map value=".authenticator.assignedEnttty" />
      </mapping>
    </element>
    <element id="DocumentReference.custodian">
      <path value="DocumentReference.custodian" />
      <short value="Organization which maintains the document" />
      <definition value="Identifies the organization or group who is responsible for ongoing maintenance of and access to the document." />
      <comment value="Identifies the logical organization (software system, vendor, or department) to go to find the current version, where to report issues, etc. This is different from the physical location (URL, disk drive, or server) of the document, which is the technical location of the document, which host may be delegated to the management of some other organization." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="DocumentReference.custodian" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.performer.actor" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.custodian" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=&quot;RCV&quot;].role[classCode=&quot;CUST&quot;].scoper[classCode=&quot;ORG&quot; and determinerCode=&quot;INST&quot;]" />
      </mapping>
    </element>
    <element id="DocumentReference.relatesTo">
      <path value="DocumentReference.relatesTo" />
      <short value="Relationships to other documents" />
      <definition value="Relationships that this document has with other document references that already exist." />
      <comment value="This element is labeled as a modifier because documents that append to other documents are incomplete on their own." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="DocumentReference.relatesTo" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.relatesTo" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry Associations" />
      </mapping>
    </element>
    <element id="DocumentReference.relatesTo.id">
      <path value="DocumentReference.relatesTo.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <condition value="ele-1" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="DocumentReference.relatesTo.extension">
      <path value="DocumentReference.relatesTo.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.relatesTo.modifierExtension">
      <path value="DocumentReference.relatesTo.modifierExtension" />
      <short value="Extensions that cannot be ignored even if unrecognized" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
      <alias value="extensions" />
      <alias value="user content" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="BackboneElement.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.relatesTo.code">
      <path value="DocumentReference.relatesTo.code" />
      <short value="The relationship type with another document" />
      <definition value="The type of relationship that this document has with anther document." />
      <comment value="If this document appends another document, then the document cannot be fully understood without also accessing the referenced document." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="DocumentReference.relatesTo.code" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DocumentRelationshipType" />
        </extension>
        <strength value="extensible" />
        <description value="The type of relationship between the documents." />
        <valueSet value="http://hl7.org/fhir/ValueSet/document-relationship-type" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.relatesTo.type" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship.typeCode" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry Associations type" />
      </mapping>
      <mapping>
        <identity value="cda" />
        <map value="ClinicalDocument/relatedDocument/typeCode" />
      </mapping>
    </element>
    <element id="DocumentReference.relatesTo.target">
      <path value="DocumentReference.relatesTo.target" />
      <short value="Target of the relationship" />
      <definition value="The target document of this relationship." />
      <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="DocumentReference.relatesTo.target" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.exists()  implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-2" />
        <severity value="error" />
        <human value="At least one of reference, identifier and display SHALL be present (unless an extension is provided)." />
        <expression value="reference.exists() or identifier.exists() or display.exists() or extension.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.relatesTo.resourceReference" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".target[classCode=&quot;DOC&quot;, moodCode=&quot;EVN&quot;].id" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry Associations reference" />
      </mapping>
      <mapping>
        <identity value="cda" />
        <map value="ClinicalDocument/relatedDocument/parentDocument" />
      </mapping>
    </element>
    <element id="DocumentReference.description">
      <path value="DocumentReference.description" />
      <short value="Human-readable description" />
      <definition value="Human-readable description of the source document." />
      <comment value="What the document is about,  a terse summary of the document." />
      <requirements value="Helps humans to assess whether the document is of interest." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="DocumentReference.description" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="markdown" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="TXA-25" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=&quot;SUBJ&quot;].target.text" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry.comments" />
      </mapping>
    </element>
    <element id="DocumentReference.securityLabel">
      <path value="DocumentReference.securityLabel" />
      <short value="Document security-tags" />
      <definition value="A set of Security-Tag codes specifying the level of privacy/security of the Document found at DocumentReference.content.attachment.url. Note that DocumentReference.meta.security contains the security labels of the data elements in DocumentReference, while DocumentReference.securityLabel contains the security labels for the document the reference refers to. The distinction recognizes that the document may contain sensitive information, while the DocumentReference is metadata about the document and thus might not be as sensitive as the document. For example: a psychotherapy episode may contain highly sensitive information, while the metadata may simply indicate that some episode happened." />
      <comment value="The confidentiality codes can carry multiple vocabulary items. HL7 has developed an understanding of security and privacy tags that might be desirable in a Document Sharing environment, called HL7 Healthcare Privacy and Security Classification System (HCS). The following specification is recommended but not mandated, as the vocabulary bindings are an administrative domain responsibility. The use of this method is up to the policy domain such as the XDS Affinity Domain or other Trust Domain where all parties including sender and recipients are trusted to appropriately tag and enforce.   &#xA;&#xA;In the HL7 Healthcare Privacy and Security Classification (HCS) there are code systems specific to Confidentiality, Sensitivity, Integrity, and Handling Caveats. Some values would come from a local vocabulary as they are related to workflow roles and special projects." />
      <requirements value="Use of the Health Care Privacy/Security Classification (HCS) system of security-tag use is recommended." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="DocumentReference.securityLabel" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="SecurityLabels" />
        </extension>
        <strength value="example" />
        <description value="Example Security Labels from the Healthcare Privacy and Security Classification System." />
        <valueSet value="http://hl7.org/fhir/ValueSet/security-label-examples" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Bundle.meta.security" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="TXA-18" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".confidentialityCode" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry.confidentialityCode" />
      </mapping>
      <mapping>
        <identity value="cda" />
        <map value="ClinicalDocument/confidentialityCode/@code" />
      </mapping>
    </element>
    <element id="DocumentReference.content">
      <path value="DocumentReference.content" />
      <short value="Document referenced" />
      <definition value="The document and format referenced.  If there are multiple content element repetitions, these must all represent the same document in different format, or attachment metadata." />
      <comment value="content element shall not contain different versions of the same content. For version handling use multiple DocumentReference with .relatesTo." />
      <requirements value="Note that .relatesTo may also include references to other DocumentReference with a transforms relationship to represent the same document in multiple formats." />
      <min value="1" />
      <max value="*" />
      <base>
        <path value="DocumentReference.content" />
        <min value="1" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Bundle(Composition+*)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="document.text" />
      </mapping>
    </element>
    <element id="DocumentReference.content.id">
      <path value="DocumentReference.content.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <condition value="ele-1" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="DocumentReference.content.extension">
      <path value="DocumentReference.content.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.content.modifierExtension">
      <path value="DocumentReference.content.modifierExtension" />
      <short value="Extensions that cannot be ignored even if unrecognized" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
      <alias value="extensions" />
      <alias value="user content" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="BackboneElement.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.content.attachment">
      <path value="DocumentReference.content.attachment" />
      <short value="Content in a format defined elsewhere" />
      <definition value="For referring to data content defined in other formats." />
      <comment value="When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as &quot;Signed Procedure Consent&quot;." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="DocumentReference.content.attachment" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="Attachment" />
        <profile value="https://fhir.synapxe.sg/StructureDefinition/profile-attachment" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="att-1" />
        <severity value="error" />
        <human value="If the Attachment has data, it SHALL have a contentType" />
        <expression value="data.empty() or contentType.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Attachment" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="ED/RP" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="ED" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.language, &#xA;Composition.title, &#xA;Composition.date" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="TXA-3 for mime type" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="document.text" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry.mimeType, DocumentEntry.languageCode, DocumentEntry.URI, DocumentEntry.size, DocumentEntry.hash, DocumentEntry.title, DocumentEntry.creationTime" />
      </mapping>
      <mapping>
        <identity value="cda" />
        <map value="ClinicalDocument/languageCode, ClinicalDocument/title, ClinicalDocument/date" />
      </mapping>
    </element>
    <element id="DocumentReference.content.profile">
      <path value="DocumentReference.content.profile" />
      <short value="Content profile rules for the document" />
      <definition value="An identifier of the document constraints, encoding, structure, and template that the document conforms to beyond the base format indicated in the mimeType." />
      <comment value="Note that IHE often issues URNs for formatCode codes, not all documents can be identified by a URI.&#xA;&#xA;For FHIR content, .profile should indicate the structureDefinition profile canonical URI(s) that the content complies with." />
      <alias value="format" />
      <alias value="formatCode" />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="DocumentReference.content.profile" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.meta.profile" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="document.text" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry.formatCode" />
      </mapping>
      <mapping>
        <identity value="cda" />
        <map value="derived from the IHE Profile or Implementation Guide templateID" />
      </mapping>
    </element>
    <element id="DocumentReference.content.profile.id">
      <path value="DocumentReference.content.profile.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <condition value="ele-1" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="DocumentReference.content.profile.extension">
      <path value="DocumentReference.content.profile.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.content.profile.modifierExtension">
      <path value="DocumentReference.content.profile.modifierExtension" />
      <short value="Extensions that cannot be ignored even if unrecognized" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
      <alias value="extensions" />
      <alias value="user content" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="BackboneElement.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="DocumentReference.content.profile.value[x]">
      <path value="DocumentReference.content.profile.value[x]" />
      <short value="Code|uri|canonical" />
      <definition value="Code|uri|canonical." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="DocumentReference.content.profile.value[x]" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <type>
        <code value="uri" />
      </type>
      <type>
        <code value="canonical" />
      </type>
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DocumentFormat" />
        </extension>
        <strength value="preferred" />
        <description value="Document Format Codes." />
        <valueSet value="http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="fhircomposition" />
        <map value="Composition.meta.profile" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="document.text" />
      </mapping>
      <mapping>
        <identity value="xds" />
        <map value="DocumentEntry.formatCode" />
      </mapping>
      <mapping>
        <identity value="cda" />
        <map value="derived from the IHE Profile or Implementation Guide templateID" />
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="DocumentReference.extension:lightDuty">
      <path value="DocumentReference.extension" />
      <sliceName value="lightDuty" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.synapxe.sg/StructureDefinition/ext-lightDuty" />
      </type>
    </element>
    <element id="DocumentReference.identifier">
      <path value="DocumentReference.identifier" />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="Identifier" />
        <profile value="https://fhir.synapxe.sg/StructureDefinition/profile-identifier" />
      </type>
    </element>
    <element id="DocumentReference.identifier.system">
      <path value="DocumentReference.identifier.system" />
      <fixedUri value="https://fhir.synapxe.sg/NamingSystem/mc-no" />
    </element>
    <element id="DocumentReference.version">
      <path value="DocumentReference.version" />
      <max value="0" />
    </element>
    <element id="DocumentReference.basedOn">
      <path value="DocumentReference.basedOn" />
      <max value="0" />
    </element>
    <element id="DocumentReference.docStatus">
      <path value="DocumentReference.docStatus" />
      <max value="0" />
    </element>
    <element id="DocumentReference.modality">
      <path value="DocumentReference.modality" />
      <max value="0" />
    </element>
    <element id="DocumentReference.type">
      <path value="DocumentReference.type" />
      <short value="Type of medicate certificate" />
      <min value="1" />
      <type>
        <code value="CodeableConcept" />
        <profile value="https://fhir.synapxe.sg/StructureDefinition/profile-codeableconcept" />
      </type>
    </element>
    <element id="DocumentReference.category">
      <path value="DocumentReference.category" />
      <max value="0" />
    </element>
    <element id="DocumentReference.subject">
      <path value="DocumentReference.subject" />
      <max value="0" />
    </element>
    <element id="DocumentReference.context">
      <path value="DocumentReference.context" />
      <max value="0" />
    </element>
    <element id="DocumentReference.event">
      <path value="DocumentReference.event" />
      <max value="0" />
    </element>
    <element id="DocumentReference.bodySite">
      <path value="DocumentReference.bodySite" />
      <max value="0" />
    </element>
    <element id="DocumentReference.facilityType">
      <path value="DocumentReference.facilityType" />
      <max value="0" />
    </element>
    <element id="DocumentReference.practiceSetting">
      <path value="DocumentReference.practiceSetting" />
      <max value="0" />
    </element>
    <element id="DocumentReference.period">
      <path value="DocumentReference.period" />
      <min value="1" />
    </element>
    <element id="DocumentReference.period.id">
      <path value="DocumentReference.period.id" />
      <max value="0" />
    </element>
    <element id="DocumentReference.period.extension">
      <path value="DocumentReference.period.extension" />
      <max value="0" />
    </element>
    <element id="DocumentReference.period.start">
      <path value="DocumentReference.period.start" />
      <min value="1" />
    </element>
    <element id="DocumentReference.period.end">
      <path value="DocumentReference.period.end" />
      <min value="1" />
    </element>
    <element id="DocumentReference.date">
      <path value="DocumentReference.date" />
      <max value="0" />
    </element>
    <element id="DocumentReference.author">
      <path value="DocumentReference.author" />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="https://fhir.synapxe.sg/StructureDefinition/profile-practitioner" />
      </type>
    </element>
    <element id="DocumentReference.author.id">
      <path value="DocumentReference.author.id" />
      <max value="0" />
    </element>
    <element id="DocumentReference.author.extension">
      <path value="DocumentReference.author.extension" />
      <max value="0" />
    </element>
    <element id="DocumentReference.author.reference">
      <path value="DocumentReference.author.reference" />
      <max value="0" />
    </element>
    <element id="DocumentReference.author.type">
      <path value="DocumentReference.author.type" />
      <fixedUri value="Practitioner" />
    </element>
    <element id="DocumentReference.author.identifier">
      <path value="DocumentReference.author.identifier" />
      <min value="1" />
      <type>
        <code value="Identifier" />
        <profile value="https://fhir.synapxe.sg/StructureDefinition/profile-identifier" />
      </type>
    </element>
    <element id="DocumentReference.author.identifier.system">
      <path value="DocumentReference.author.identifier.system" />
      <fixedUri value="https://fhir.synapxe.sg/NamingSystem/mcr" />
    </element>
    <element id="DocumentReference.attester">
      <path value="DocumentReference.attester" />
      <max value="0" />
    </element>
    <element id="DocumentReference.custodian">
      <path value="DocumentReference.custodian" />
      <max value="0" />
    </element>
    <element id="DocumentReference.relatesTo">
      <path value="DocumentReference.relatesTo" />
      <max value="0" />
    </element>
    <element id="DocumentReference.description">
      <path value="DocumentReference.description" />
      <max value="0" />
    </element>
    <element id="DocumentReference.securityLabel">
      <path value="DocumentReference.securityLabel" />
      <max value="0" />
    </element>
    <element id="DocumentReference.content.id">
      <path value="DocumentReference.content.id" />
      <max value="0" />
    </element>
    <element id="DocumentReference.content.extension">
      <path value="DocumentReference.content.extension" />
      <max value="0" />
    </element>
    <element id="DocumentReference.content.modifierExtension">
      <path value="DocumentReference.content.modifierExtension" />
      <max value="0" />
    </element>
    <element id="DocumentReference.content.attachment">
      <path value="DocumentReference.content.attachment" />
      <type>
        <code value="Attachment" />
        <profile value="https://fhir.synapxe.sg/StructureDefinition/profile-attachment" />
      </type>
    </element>
    <element id="DocumentReference.content.profile">
      <path value="DocumentReference.content.profile" />
      <max value="0" />
    </element>
  </differential>
</StructureDefinition>