<status value="draft" /> <date value="2020-11-18T16:04:17.8148173Z" /> <description value="Clinical document used to represent a Patient Chart. This is compliant to the International Patient Summary (IPS) data set." /> <fhirVersion value="4.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Pattern" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="cda" /> <uri value="http://hl7.org/v3/cda" /> <name value="CDA (R2)" /> </mapping> <mapping> <identity value="fhirdocumentreference" /> <uri value="http://hl7.org/fhir/documentreference" /> <name value="FHIR DocumentReference" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/fivews" /> <name value="FiveWs Pattern Mapping" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Composition" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Composition" /> <derivation value="constraint" /> <differential> <element id="Composition"> <path value="Composition" /> <comment value="Usage: Depending on the use case for Patient Chart, a composition may or may not be used. Example: If sent with a MedDialog message, a composition will be used as there will be an accompanying PDF and a document reference. Alignment PS-ON: When the EMR contains text only for a procedure and cannot distinguish procedure from condition, it is acceptable to include the procedure under past history of illness. *This applies to the Patient Chart as well DISCUSSION: DO WE NEED TO ADD A REFERENCE BACK TO THE DOCUMENT REFERENCE/PDF VERSION OF THIS? DO WE NEED TO ADD AN EXTENSION FOR CLINICAL DOCUMENT VERSION NUMBER (exists in clinical document profile FHIR) While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical." /> </element> <element id="Composition.id"> <path value="Composition.id" /> <comment value="Usage Note: This will usually be a GUID that is assigned by the sending application. The only time that a resource does not have an id is when it is being submitted to the server using a create operation." /> <mustSupport value="true" /> </element> <element id="Composition.meta"> <path value="Composition.meta" /> <mustSupport value="true" /> </element> <element id="Composition.meta.lastUpdated"> <path value="Composition.meta.lastUpdated" /> <mustSupport value="true" /> </element> <element id="Composition.meta.source"> <path value="Composition.meta.source" /> <mustSupport value="true" /> </element> <element id="Composition.meta.profile"> <path value="Composition.meta.profile" /> <comment value="Usage: This will be determined by each implementer. This may be useful for validating message instances. It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set." /> <mustSupport value="true" /> </element> <element id="Composition.meta.security"> <path value="Composition.meta.security" /> <mustSupport value="true" /> </element> <element id="Composition.language"> <path value="Composition.language" /> <comment value="BC - mandatory; support english only - conformance rule? Discusison - is english only appropriate? mandatory 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="1" /> <mustSupport value="true" /> </element> <element id="Composition.text"> <path value="Composition.text" /> <comment value="Usage Note: Use case: Patient Chart Referral and EMR Patient Chart Transfer, External : This will be a PDF wrapped inside HTML that will convey the entire composition (all resources in the bundle) in PDF form. Alignment: PS-ON aligns with IPS and PS-CA where this data element is Must Support and optional. This does not need to be populated until Ontario provides further direction to vendors; we can propose the same approach Note: This should be treated as mandatory for use cases that ultimately result in a CDA L1. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later." /> <mustSupport value="true" /> </element> <element id="Composition.identifier"> <path value="Composition.identifier" /> <comment value="Usage Note: This can be genereated as a UUID; mandatory to align with ON-PS and may be generated in the same fashion as ON-PS. ON-PS Usage Note: PoS systems are not expected to use the same value for all instances of a single patient summary and are not expected to preserve this identifier. It may be a generated value such as UUID. DISCUSSION REQUIRED Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate." /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.identifier.system"> <path value="Composition.identifier.system" /> <mustSupport value="true" /> </element> <element id="Composition.identifier.value"> <path value="Composition.identifier.value" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.status"> <path value="Composition.status" /> <mustSupport value="true" /> </element> <element id="Composition.type"> <path value="Composition.type" /> <comment value="Usage Note: In future releases, a full set of LOINC codes (including LOINC.Ontology codes) will be added to this value set. Implementers should expect that this value set will be provided outside of the specification. *Work to reconcile these codes to align with CDA, eg CDX partner - refer to terminology work. PS-ON and PS-CA- Pattern: system": "http://loinc.org", "code": "60591-5" (Patient Summary Document) Conformance Rule: This must be specified when known. Set type to the best, most precise LOINC code corresponding to the concept of the document in the source system. Conformance Rule: If available, a local code must be supplied as well (code, system, mandatory text, userSelected). Conformance Rule: ??? confirm there is always a code; else what? FHIR: For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding." /> <mustSupport value="true" /> <binding> <strength value="extensible" /> </binding> </element> <element id="Composition.type.coding"> <path value="Composition.type.coding" /> <mustSupport value="true" /> </element> <element id="Composition.type.coding.system"> <path value="Composition.type.coding.system" /> <fixedUri value="http://loinc.org" /> <mustSupport value="true" /> </element> <element id="Composition.type.coding.code"> <path value="Composition.type.coding.code" /> <comment value="Usage Rule: The code value must be 60591-5 for the patient chart (patient summary). This aligns with the IPS. Other codes may be relevant, such as Patient Chart, or DW Extract. Note that FHIR strings SHALL NOT exceed 1MB in size" /> <mustSupport value="true" /> </element> <element id="Composition.type.coding.display"> <path value="Composition.type.coding.display" /> <mustSupport value="true" /> </element> <element id="Composition.type.coding.userSelected"> <path value="Composition.type.coding.userSelected" /> <mustSupport value="true" /> </element> <element id="Composition.type.text"> <path value="Composition.type.text" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.category"> <path value="Composition.category" /> <comment value="Conformance Rule: Populate category with the best, most precise LOINC code corresponding to each category code in the source system. Multiple categories may be specified in some cases. Example: A document could be categorized as both a Discharge Summary and a Post-Operative Report. Usage Rule: The POS must send a local code and the LOINC code. Usage Note: In future releases a full set of LOINC codes (including LOINC.Ontology codes) will be added to this value set. Implementers should expect that this value set will be provided outside of the specification. Alignment: Not supported in PS-ON or PS-CA No map to CDA FHIR: This is a metadata field from [XDS/MHD](http://wiki.ihe.net/index.php?title=Mobile_access_to_Health_Documents_(MHD))." /> <mustSupport value="true" /> <binding> <strength value="extensible" /> </binding> </element> <element id="Composition.category.coding"> <path value="Composition.category.coding" /> <mustSupport value="true" /> </element> <element id="Composition.category.coding.system"> <path value="Composition.category.coding.system" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.category.coding.code"> <path value="Composition.category.coding.code" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.category.coding.display"> <path value="Composition.category.coding.display" /> <mustSupport value="true" /> </element> <element id="Composition.category.coding.userSelected"> <path value="Composition.category.coding.userSelected" /> <mustSupport value="true" /> </element> <element id="Composition.category.text"> <path value="Composition.category.text" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.subject"> <path value="Composition.subject" /> <min value="1" /> <type> <code value="Reference" /> <aggregation value="bundled" /> </type> <mustSupport value="true" /> </element> <element id="Composition.subject.reference"> <path value="Composition.subject.reference" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.subject.display"> <path value="Composition.subject.display" /> <comment value="Usage Note: This should contain the name of the Patient, which can then be used in narrative 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="1" /> <mustSupport value="true" /> </element> <element id="Composition.date"> <path value="Composition.date" /> <mustSupport value="true" /> </element> <element id="Composition.author"> <path value="Composition.author" /> <comment value="DISCUSS REQUIRED TO CONSTRAIN References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" /> <aggregation value="bundled" /> </type> <mustSupport value="true" /> </element> <element id="Composition.author.reference"> <path value="Composition.author.reference" /> <mustSupport value="true" /> </element> <element id="Composition.author.display"> <path value="Composition.author.display" /> <mustSupport value="true" /> </element> <element id="Composition.title"> <path value="Composition.title" /> <mustSupport value="true" /> </element> <element id="Composition.confidentiality"> <path value="Composition.confidentiality" /> <comment value="BC - this is mandatory - determine if this is always available in the EMR's and whether we can make it mandatory PS-ON: supported The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not." /> <mustSupport value="true" /> </element> <element id="Composition.attester"> <path value="Composition.attester" /> <comment value="**We are not aligned; PS-ON has this as a mandatory element Only list each attester once." /> </element> <element id="Composition.custodian"> <path value="Composition.custodian" /> <comment value="Discussion: we may wish to include the Organization as this shoud be treated separately; not sending org in the 301 This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged." /> <mustSupport value="true" /> </element> <element id="Composition.custodian.reference"> <path value="Composition.custodian.reference" /> <mustSupport value="true" /> </element> <element id="Composition.custodian.display"> <path value="Composition.custodian.display" /> <mustSupport value="true" /> </element> <element id="Composition.relatesTo"> <path value="Composition.relatesTo" /> <comment value="Usage Note: Not required for Patient Chart; this is in scope for PS_ON and others. A document is a version specific composition." /> <mustSupport value="true" /> </element> <element id="Composition.event"> <path value="Composition.event" /> <comment value="Usage Rule: Not required in the patient chart; if it is to be populated, this should range from the date of the earliest entry in the chart to the most recent entry in the chart. Alignment: PS-ON There is no overall clinical event required. PS-ON has adopted guidance from IPS (included in the Composition profile) stating that "For example if the PS is generated by a GP based on information recorded in his/her EHR-S, then the start value should represent the date when the treatment relationship between the patient and the GP started; and the end value the date of the latest care event." BC - The IHE XD-LAB technical framework defines an extension to CDA to enable sharing of non-final lab result reports; it adds an optional sub element of statusCode in documentationOf/serviceEvent. The event needs to be consistent with the type element, though can provide further information if desired." /> <mustSupport value="true" /> </element> <element id="Composition.event.period"> <path value="Composition.event.period" /> <comment value="BC - A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." /> <mustSupport value="true" /> </element> <element id="Composition.section"> <path value="Composition.section" /> <slicing> <discriminator> <type value="pattern" /> <path value="code" /> </discriminator> <rules value="open" /> </slicing> <comment value="Alignment: In both PS-ON and PS-CA the Medication, Allergy and Problem sections are mandatory." /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section.title"> <path value="Composition.section.title" /> <comment value="CDX - Title is mandatory The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." /> <mustSupport value="true" /> </element> <element id="Composition.section.code"> <path value="Composition.section.code" /> <mustSupport value="true" /> </element> <element id="Composition.section.text"> <path value="Composition.section.text" /> <comment value="Usage Note: This is a rolled up version of all resources in this section. eg if a patient has 5 allergies (5 resources), this can provide a summary view of everything, eg 5 allergies; A, B, C, D, E. Ths may also be used for sections that do not have any entries/resources. Usage Note: For Patient Chart, this should contain the PDF rendering of the entire Patient Chart. Alignment PS-ON: PS-ON aligns with IPS and PS-CA where this data element is Must Support and optional. CDX - mandatory Document profiles may define what content should be represented in the narrative to ensure clinical safety." /> <mustSupport value="true" /> </element> <element id="Composition.section.entry"> <path value="Composition.section.entry" /> <mustSupport value="true" /> </element> <element id="Composition.section.entry.reference"> <path value="Composition.section.entry.reference" /> <mustSupport value="true" /> </element> <element id="Composition.section.section"> <path value="Composition.section.section" /> <comment value="Usage: There is no use case identified; potential future use Nested sections are primarily used to help human readers navigate to particular portions of the document." /> <contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" /> </element> <element id="Composition.section.section.title"> <path value="Composition.section.section.title" /> <mustSupport value="true" /> </element> <element id="Composition.section.section.code"> <path value="Composition.section.section.code" /> <mustSupport value="true" /> </element> <element id="Composition.section.section.text"> <path value="Composition.section.section.text" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section.section.orderedBy"> <path value="Composition.section.section.orderedBy" /> <mustSupport value="true" /> </element> <element id="Composition.section.section.entry"> <path value="Composition.section.section.entry" /> <min value="1" /> <max value="1" /> <type> <code value="Reference" /> <aggregation value="bundled" /> </type> <mustSupport value="true" /> </element> <element id="Composition.section.section.entry.reference"> <path value="Composition.section.section.entry.reference" /> <mustSupport value="true" /> </element> <element id="Composition.section.section.section"> <path value="Composition.section.section.section" /> <contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" /> </element> <element id="Composition.section:Medications"> <path value="Composition.section" /> <sliceName value="Medications" /> <comment value="Conformance rule: If the EMR has recorded "No known medications" this should be sent where possible. If there is nothing recorded in the EMR this should be mandatory where possible to record the data absent reason." /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Medications.title"> <path value="Composition.section.title" /> <mustSupport value="true" /> </element> <element id="Composition.section:Medications.code"> <path value="Composition.section.code" /> <comment value="Note: LOINC 10160-0 = History of Medication use Narrative The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." /> <min value="1" /> <fixedCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="10160-0" /> </coding> </fixedCodeableConcept> <mustSupport value="true" /> </element> <element id="Composition.section:Medications.text"> <path value="Composition.section.text" /> <comment value="PS-ON and PS-CA; Mandatory Document profiles may define what content should be represented in the narrative to ensure clinical safety." /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Medications.entry"> <path value="Composition.section.entry" /> <min value="1" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" /> <targetProfile value="http://telus.com/fhir/patientChart/StructureDefinition/profile-medication-order" /> <targetProfile value="http://telus.com/fhir/patientChart/StructureDefinition/profile-medication-plan" /> <targetProfile value="http://telus.com/fhir/patientChart/StructureDefinition/profile-medication-statement" /> <targetProfile value="http://telus.com/fhir/patientChart/StructureDefinition/profile-medication-administration" /> <aggregation value="bundled" /> </type> <mustSupport value="true" /> </element> <element id="Composition.section:Medications.emptyReason"> <path value="Composition.section.emptyReason" /> <max value="0" /> </element> <element id="Composition.section:Medications.section"> <path value="Composition.section.section" /> <max value="0" /> <contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" /> </element> <element id="Composition.section:Allergies"> <path value="Composition.section" /> <sliceName value="Allergies" /> <comment value="Conformance rule: If the EMR has recorded "No known allergies" this should be sent where possible. If there is nothing recorded in the EMR this should be mandatory where possible to record the data absent reason." /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Allergies.title"> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Allergies.code"> <path value="Composition.section.code" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Allergies.code.coding"> <path value="Composition.section.code.coding" /> <min value="1" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Allergies.code.coding.system"> <path value="Composition.section.code.coding.system" /> <min value="1" /> <fixedUri value="http://loinc.org" /> <mustSupport value="true" /> </element> <element id="Composition.section:Allergies.code.coding.code"> <path value="Composition.section.code.coding.code" /> <min value="1" /> <fixedCode value="48765-2" /> <mustSupport value="true" /> </element> <element id="Composition.section:Allergies.text"> <path value="Composition.section.text" /> <mustSupport value="true" /> </element> <element id="Composition.section:Allergies.entry"> <path value="Composition.section.entry" /> <min value="1" /> <type> <code value="Reference" /> <targetProfile value="http://telus.com/fhir/patientChart/StructureDefinition/profile-allergyIntolerance" /> <aggregation value="bundled" /> </type> <mustSupport value="true" /> </element> <element id="Composition.section:Allergies.entry.reference"> <path value="Composition.section.entry.reference" /> <min value="1" /> <fixedString value="http://telus.com/fhir/patientChart/StructureDefinition/profile-allergyIntolerance-patientchart" /> <mustSupport value="true" /> </element> <element id="Composition.section:Allergies.emptyReason"> <path value="Composition.section.emptyReason" /> <max value="0" /> </element> <element id="Composition.section:Allergies.section"> <path value="Composition.section.section" /> <max value="0" /> <contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" /> </element> <element id="Composition.section:Problems"> <path value="Composition.section" /> <sliceName value="Problems" /> <comment value="Conformance rule: If there is nothing recorded in the EMR this should be mandatory where possible to record the data absent reason." /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Problems.title"> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Problems.code"> <path value="Composition.section.code" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Problems.code.coding"> <path value="Composition.section.code.coding" /> <min value="1" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Problems.code.coding.system"> <path value="Composition.section.code.coding.system" /> <min value="1" /> <fixedUri value="http://loinc.org" /> <mustSupport value="true" /> </element> <element id="Composition.section:Problems.code.coding.code"> <path value="Composition.section.code.coding.code" /> <min value="1" /> <fixedCode value="11450-4" /> <mustSupport value="true" /> </element> <element id="Composition.section:Problems.text"> <path value="Composition.section.text" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Problems.entry"> <path value="Composition.section.entry" /> <min value="1" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="http://telus.com/fhir/patientChart/StructureDefinition/profile-condition" /> <aggregation value="bundled" /> </type> <mustSupport value="true" /> </element> <element id="Composition.section:Problems.emptyReason"> <path value="Composition.section.emptyReason" /> <max value="0" /> </element> <element id="Composition.section:Problems.section"> <path value="Composition.section.section" /> <max value="0" /> <contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" /> </element> <element id="Composition.section:ProceduresHx"> <path value="Composition.section" /> <sliceName value="ProceduresHx" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:ProceduresHx.code"> <path value="Composition.section.code" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:ProceduresHx.code.coding"> <path value="Composition.section.code.coding" /> <min value="1" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:ProceduresHx.code.coding.system"> <path value="Composition.section.code.coding.system" /> <min value="1" /> <fixedUri value="http://loinc.org" /> <mustSupport value="true" /> </element> <element id="Composition.section:ProceduresHx.code.coding.code"> <path value="Composition.section.code.coding.code" /> <min value="1" /> <fixedCode value="47519-4" /> <mustSupport value="true" /> </element> <element id="Composition.section:ProceduresHx.text"> <path value="Composition.section.text" /> <mustSupport value="true" /> </element> <element id="Composition.section:ProceduresHx.entry"> <path value="Composition.section.entry" /> <min value="1" /> <type> <code value="Reference" /> <targetProfile value="http://telus.com/fhir/patientChart/StructureDefinition/profile-procedure" /> <aggregation value="bundled" /> </type> <mustSupport value="true" /> </element> <element id="Composition.section:ProceduresHx.emptyReason"> <path value="Composition.section.emptyReason" /> <max value="0" /> </element> <element id="Composition.section:ProceduresHx.section"> <path value="Composition.section.section" /> <max value="0" /> <contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" /> </element> <element id="Composition.section:Immunizations"> <path value="Composition.section" /> <sliceName value="Immunizations" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Immunizations.title"> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Immunizations.code"> <path value="Composition.section.code" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Immunizations.code.coding"> <path value="Composition.section.code.coding" /> <min value="1" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Immunizations.code.coding.system"> <path value="Composition.section.code.coding.system" /> <min value="1" /> <fixedUri value="http://loinc.org" /> <mustSupport value="true" /> </element> <element id="Composition.section:Immunizations.code.coding.code"> <path value="Composition.section.code.coding.code" /> <min value="1" /> <fixedCode value="11369-6" /> <mustSupport value="true" /> </element> <element id="Composition.section:Immunizations.text"> <path value="Composition.section.text" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Immunizations.entry"> <path value="Composition.section.entry" /> <min value="1" /> <type> <code value="Reference" /> <targetProfile value="http://telus.com/fhir/patientChart/StructureDefinition/profile-immunization" /> <aggregation value="bundled" /> </type> <mustSupport value="true" /> </element> <element id="Composition.section:Immunizations.emptyReason"> <path value="Composition.section.emptyReason" /> <max value="0" /> </element> <element id="Composition.section:Immunizations.section"> <path value="Composition.section.section" /> <max value="0" /> <contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" /> </element> <element id="Composition.section:VitalSigns"> <path value="Composition.section" /> <sliceName value="VitalSigns" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:VitalSigns.title"> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:VitalSigns.code"> <path value="Composition.section.code" /> <comment value="Usage: 8716-3 Vital signs LOINC The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:VitalSigns.code.coding"> <path value="Composition.section.code.coding" /> <min value="1" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:VitalSigns.code.coding.system"> <path value="Composition.section.code.coding.system" /> <min value="1" /> <fixedUri value="http://loinc.org" /> <mustSupport value="true" /> </element> <element id="Composition.section:VitalSigns.code.coding.code"> <path value="Composition.section.code.coding.code" /> <min value="1" /> <fixedCode value="8716-3" /> <mustSupport value="true" /> </element> <element id="Composition.section:VitalSigns.text"> <path value="Composition.section.text" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:VitalSigns.entry"> <path value="Composition.section.entry" /> <min value="1" /> <type> <code value="Reference" /> <targetProfile value="http://telus.com/fhir/patientChart/StructureDefinition/profile-observation-vitals" /> <aggregation value="bundled" /> </type> <mustSupport value="true" /> </element> <element id="Composition.section:VitalSigns.entry.reference"> <path value="Composition.section.entry.reference" /> <min value="1" /> </element> <element id="Composition.section:VitalSigns.emptyReason"> <path value="Composition.section.emptyReason" /> <max value="0" /> </element> <element id="Composition.section:VitalSigns.section"> <path value="Composition.section.section" /> <max value="0" /> <contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" /> </element> <element id="Composition.section:Results"> <path value="Composition.section" /> <sliceName value="Results" /> <comment value="Usage Note: This section will convey labs which can be a Diagnostic Report with Observations, or individual observations. The human readable form (eg PDF) assocaited with each lab report will be an attachment (Presented Form) in the Diagnostic Report." /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Results.title"> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Results.code"> <path value="Composition.section.code" /> <comment value="Usage Note: This code reflects the nature of the Diagnostic Report section; code aligns with PS-CA The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." /> <mustSupport value="true" /> </element> <element id="Composition.section:Results.code.coding"> <path value="Composition.section.code.coding" /> <min value="1" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Results.code.coding.system"> <path value="Composition.section.code.coding.system" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Results.code.coding.code"> <path value="Composition.section.code.coding.code" /> <min value="1" /> <fixedCode value="30954-2" /> <mustSupport value="true" /> </element> <element id="Composition.section:Results.code.coding.display"> <path value="Composition.section.code.coding.display" /> <comment value="Value = Relevant diagnostic tests &or laboratory data Note that FHIR strings SHALL NOT exceed 1MB in size" /> </element> <element id="Composition.section:Results.text"> <path value="Composition.section.text" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Results.entry"> <path value="Composition.section.entry" /> <min value="1" /> <type> <code value="Reference" /> <targetProfile value="http://telus.com/fhir/patientChart/StructureDefinition/profile-observation-lab" /> <targetProfile value="http://telus.com/fhir/patientChart/StructureDefinition/profile-diagnostic-report" /> <aggregation value="bundled" /> </type> <mustSupport value="true" /> </element> <element id="Composition.section:Results.entry.reference"> <path value="Composition.section.entry.reference" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:Results.emptyReason"> <path value="Composition.section.emptyReason" /> <max value="0" /> </element> <element id="Composition.section:Results.section"> <path value="Composition.section.section" /> <max value="0" /> <contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" /> </element> <element id="Composition.section:SocialHistory"> <path value="Composition.section" /> <sliceName value="SocialHistory" /> <mustSupport value="true" /> </element> <element id="Composition.section:SocialHistory.title"> <path value="Composition.section.title" /> <comment value="Usage Note: Suggested title = "Social History" if this section covers multiple observations. The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." /> <mustSupport value="true" /> </element> <element id="Composition.section:SocialHistory.code"> <path value="Composition.section.code" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:SocialHistory.code.coding"> <path value="Composition.section.code.coding" /> <min value="1" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:SocialHistory.code.coding.system"> <path value="Composition.section.code.coding.system" /> <min value="1" /> <fixedUri value="http://loinc.org" /> <mustSupport value="true" /> </element> <element id="Composition.section:SocialHistory.code.coding.code"> <path value="Composition.section.code.coding.code" /> <min value="1" /> <fixedCode value="29762-2" /> <mustSupport value="true" /> </element> <element id="Composition.section:SocialHistory.entry"> <path value="Composition.section.entry" /> <type> <code value="Reference" /> <profile value="http://telus.com/fhir/patientChartStructureDefinition/profile-ObservationAlcoholUse" /> <profile value="http://telus.com/fhir/patientChart/StructureDefinition/profile-observation-tobacco-use" /> <profile value="http://telus.com/fhir/patientChart/StructureDefinition/profile-observation-social-history" /> <aggregation value="bundled" /> </type> <mustSupport value="true" /> </element> <element id="Composition.section:SocialHistory.entry.reference"> <path value="Composition.section.entry.reference" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:SocialHistory.entry.display"> <path value="Composition.section.entry.display" /> <mustSupport value="true" /> </element> <element id="Composition.section:SocialHistory.section"> <path value="Composition.section.section" /> <contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" /> </element> <element id="Composition.section:FamilyHistory"> <path value="Composition.section" /> <sliceName value="FamilyHistory" /> </element> <element id="Composition.section:FamilyHistory.title"> <path value="Composition.section.title" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:FamilyHistory.code"> <path value="Composition.section.code" /> <mustSupport value="true" /> </element> <element id="Composition.section:FamilyHistory.text"> <path value="Composition.section.text" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Composition.section:FamilyHistory.entry"> <path value="Composition.section.entry" /> <min value="1" /> <type> <code value="Reference" /> <targetProfile value="https://telus.com/fhir/patientChart/StructureDefinition/profile-family-member-history" /> <aggregation value="bundled" /> </type> <mustSupport value="true" /> </element> <element id="Composition.section:FamilyHistory.emptyReason"> <path value="Composition.section.emptyReason" /> <max value="0" /> </element> <element id="Composition.section:FamilyHistory.section"> <path value="Composition.section.section" /> <max value="0" /> <contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" /> </element> <element id="Composition.section:PregnancyHx"> <path value="Composition.section" /> <sliceName value="PregnancyHx" /> </element> <element id="Composition.section:PregnancyHx.title"> <path value="Composition.section.title" /> <mustSupport value="true" /> </element> <element id="Composition.section:PregnancyHx.code"> <path value="Composition.section.code" /> <mustSupport value="true" /> </element> <element id="Composition.section:PregnancyHx.code.text"> <path value="Composition.section.code.text" /> <mustSupport value="true" /> </element> <element id="Composition.section:PregnancyHx.text"> <path value="Composition.section.text" /> <mustSupport value="true" /> </element> <element id="Composition.section:PregnancyHx.entry"> <path value="Composition.section.entry" /> <mustSupport value="true" /> </element> <element id="Composition.section:PregnancyHx.emptyReason"> <path value="Composition.section.emptyReason" /> <max value="0" /> </element> <element id="Composition.section:PregnancyHx.section"> <path value="Composition.section.section" /> <max value="0" /> <contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section" /> </element> </differential> </StructureDefinition>