<StructureDefinition xmlns="http://hl7.org/fhir">
  <!-- <url value="http://example.org/fhir/StructureDefinition/MyMessageDefinition" /> -->
  <name value="Genomics-MessageDefinition-1" />
  <status value="draft" />
  <fhirVersion value="4.0.0" />
  <mapping>
    <identity value="v2" />
    <uri value="http://hl7.org/v2" />
    <name value="HL7 v2 Mapping" />
  </mapping>
  <mapping>
    <identity value="rim" />
    <uri value="http://hl7.org/v3" />
    <name value="RIM Mapping" />
  </mapping>
  <mapping>
    <identity value="w5" />
    <uri value="http://hl7.org/fhir/w5" />
    <name value="W5 Mapping" />
  </mapping>
  <mapping>
    <identity value="objimpl" />
    <uri value="http://hl7.org/fhir/object-implementation" />
    <name value="Object Implementation Information" />
  </mapping>
  <kind value="resource" />
  <abstract value="false" />
  <type value="MessageDefinition" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/MessageDefinition" />
  <derivation value="constraint" />
  <snapshot>
    <element id="MessageDefinition">
      <path value="MessageDefinition" />
      <short value="A resource that defines a type of message that can be exchanged between systems" />
      <definition value="Defines the characteristics of a message that can be shared between systems, including the type of event that initiates the message, the content to be transmitted and what response(s), if any, are permitted." />
      <comment value="This would be a MIF-level artifact." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Resource" />
        <min value="0" />
        <max value="*" />
      </base>
      <constraint>
        <key value="dom-2" />
        <severity value="error" />
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
        <expression value="contained.contained.empty()" />
        <xpath value="not(parent::f:contained and f:contained)" />
      </constraint>
      <constraint>
        <key value="dom-1" />
        <severity value="error" />
        <human value="If the resource is contained in another resource, it SHALL NOT contain any narrative" />
        <expression value="contained.text.empty()" />
        <xpath value="not(parent::f:contained and f:text)" />
      </constraint>
      <constraint>
        <key value="dom-4" />
        <severity value="error" />
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
        <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
      </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" />
        <expression value="contained.where(('#'+id in %resource.descendants().reference).not()).empty()" />
        <xpath value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="Entity. Role, or Act" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="infrastructure.exchange" />
      </mapping>
    </element>
    <element id="MessageDefinition.id">
      <path value="MessageDefinition.id" />
      <short value="Logical id of this artifact" />
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
      <comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="id" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.meta">
      <path value="MessageDefinition.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 may 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>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </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="MessageDefinition.implicitRules">
      <path value="MessageDefinition.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." />
      <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. &#xA;&#xA;This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.implicitRules" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isModifier value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.language">
      <path value="MessageDefinition.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>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference value="http://hl7.org/fhir/ValueSet/all-languages" />
          </valueReference>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true" />
        </extension>
        <strength value="extensible" />
        <description value="A human language." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/languages" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.text">
      <path value="MessageDefinition.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 may 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 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 in formation 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="ele-1" />
      <condition value="dom-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <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="MessageDefinition.contained">
      <path value="MessageDefinition.contained" />
      <short value="Contained, inline Resources" />
      <definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope." />
      <comment value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again." />
      <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>
      <mapping>
        <identity value="rim" />
        <map value="Entity. Role, or Act" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="MessageDefinition.extension">
      <path value="MessageDefinition.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. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <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>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="MessageDefinition.modifierExtension">
      <path value="MessageDefinition.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. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." />
      <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.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
      </constraint>
      <isModifier value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="MessageDefinition.url">
      <path value="MessageDefinition.url" />
      <short value="Logical URI to reference this message definition (globally unique)" />
      <definition value="An absolute URI that is used to identify this message definition when it is referenced in a specification, model, design or an instance. This SHALL be a URL, SHOULD be globally unique, and SHOULD be an address at which this message definition is (or will be) published. The URL SHOULD include the major version of the message definition. For more information see [Technical and Business Versions](resource.html#versions)." />
      <comment value="Can be a urn:uuid: or a urn:oid:, but real http: addresses are preferred.  Multiple instances may share the same url if they have a distinct version." />
      <requirements value="Allows the message definition to be referenced by a single globally unique identifier." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.url" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="id" />
      </mapping>
    </element>
    <element id="MessageDefinition.identifier">
      <path value="MessageDefinition.identifier" />
      <short value="Additional identifier for the message definition" />
      <definition value="A formal identifier that is used to identify this message definition when it is represented in other formats, or referenced in a specification, model, design or an instance." />
      <comment value="Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, e.g., to identify this message definition outside of FHIR, where it is not possible to use the logical URI." />
      <requirements value="Allows externally provided and/or usable business identifiers to be easily associated with the module." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MessageDefinition.identifier" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Identifier" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </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 - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. 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="objimpl" />
        <map value="no-gen-base" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="id" />
      </mapping>
    </element>
    <element id="MessageDefinition.version">
      <path value="MessageDefinition.version" />
      <short value="Business version of the message definition" />
      <definition value="The identifier that is used to identify this version of the message definition when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the message definition author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence." />
      <comment value="There may be different message definition instances that have the same identifier but different versions.  The version can be appended to the url in a reference to allow a refrence to a particular business version of the message definition with the format [url]|[version]." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.version" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="id.version" />
      </mapping>
    </element>
    <element id="MessageDefinition.name">
      <path value="MessageDefinition.name" />
      <short value="Name for this message definition (computer friendly)" />
      <definition value="A natural language name identifying the message definition. This name should be usable as an identifier for the module by machine processing applications such as code generation." />
      <comment value="The name is not expected to be globally unique. The name should be a simple alpha-numeric type name to ensure that it is computable friendly." />
      <requirements value="Support human navigation and code generation." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.name" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.title">
      <path value="MessageDefinition.title" />
      <short value="Name for this message definition (human friendly)" />
      <definition value="A short, descriptive, user-friendly title for the message definition." />
      <comment value="This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.title" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.status">
      <path value="MessageDefinition.status" />
      <short value="draft | active | retired | unknown" />
      <definition value="The status of this message definition. Enables tracking the life-cycle of the content." />
      <comment value="Allows filtering of message definitions that are appropriate for use vs. not.  &#xA;This is labeled as &quot;Is Modifier&quot; because applications should not use a retired message definition without due consideration." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.status" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isModifier value="true" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="PublicationStatus" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true" />
        </extension>
        <strength value="required" />
        <description value="The lifecycle status of a Value Set or Concept Map." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/publication-status|4.0.0" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="status" />
      </mapping>
    </element>
    <element id="MessageDefinition.experimental">
      <path value="MessageDefinition.experimental" />
      <short value="For testing purposes, not real usage" />
      <definition value="A boolean value to indicate that this message definition is authored for testing purposes (or education/evaluation/marketing), and is not intended to be used for genuine usage." />
      <comment value="Allows filtering of message definition that are appropriate for use vs. not. This is labeled as &quot;Is Modifier&quot; because applications should not use an experimental message definition in production." />
      <requirements value="Enables experimental content to be developed following the same lifecycle that would be used for a production-level message definition." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.experimental" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isModifier value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="class" />
      </mapping>
    </element>
    <element id="MessageDefinition.date">
      <path value="MessageDefinition.date" />
      <short value="Date this was last changed" />
      <definition value="The date  (and optionally time) when the message definition was published. The date must change if and when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the message definition changes." />
      <comment value="Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the message definition. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource." />
      <alias value="Revision Date" />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.date" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="when.recorded" />
      </mapping>
    </element>
    <element id="MessageDefinition.publisher">
      <path value="MessageDefinition.publisher" />
      <short value="Name of the publisher (organization or individual)" />
      <definition value="The name of the individual or organization that published the message definition." />
      <comment value="Usually an organization, but may be an individual. The publisher (or steward) of the message definition is the organization or individual primarily responsible for the maintenance and upkeep of the message definition. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the message definition. This item SHOULD be populated unless the information is available from context." />
      <requirements value="Helps establish the &quot;authority/credibility&quot; of the message definition.  May also allow for contact." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.publisher" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="who.witness" />
      </mapping>
    </element>
    <element id="MessageDefinition.contact">
      <path value="MessageDefinition.contact" />
      <short value="Contact details for the publisher" />
      <definition value="Contact details to assist a user in finding and communicating with the publisher." />
      <comment value="May be a web site, an email address, a telephone number, etc." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MessageDefinition.contact" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="ContactDetail" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.description">
      <path value="MessageDefinition.description" />
      <short value="Natural language description of the message definition" />
      <definition value="A free text natural language description of the message definition from a consumer's perspective." />
      <comment value="This description can be used to capture details such as why the message definition was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the message definition as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the profile is presumed to be the predominant language in the place the profile was created)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.description" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="markdown" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.useContext">
      <path value="MessageDefinition.useContext" />
      <short value="Context the content is intended to support" />
      <definition value="The content was developed with a focus and intent of supporting the contexts that are listed. These terms may be used to assist with indexing and searching for appropriate message definition instances." />
      <comment value="When multiple useContexts are specified, there is no expectation whether all or any of the contexts apply." />
      <requirements value="Assist in searching for appropriate content." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MessageDefinition.useContext" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="UsageContext" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.jurisdiction">
      <path value="MessageDefinition.jurisdiction" />
      <short value="Intended jurisdiction for message definition (if applicable)" />
      <definition value="A legal or geographic region in which the message definition is intended to be used." />
      <comment value="It may be possible for the message definition to be used in jurisdictions other than those for which it was originally designed or intended." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MessageDefinition.jurisdiction" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Jurisdiction" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true" />
        </extension>
        <strength value="extensible" />
        <description value="Countries and regions within which this artifact is targeted for use" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/jurisdiction" />
        </valueSetReference>
      </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>
    </element>
    <element id="MessageDefinition.jurisdiction.id">
      <path value="MessageDefinition.jurisdiction.id" />
      <representation value="xmlAttr" />
      <short value="xml:id (or equivalent in JSON)" />
      <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <comment value="Note that FHIR strings may not exceed 1MB in size" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.jurisdiction.extension">
      <path value="MessageDefinition.jurisdiction.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. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <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>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="MessageDefinition.jurisdiction.coding">
      <path value="MessageDefinition.jurisdiction.coding" />
      <short value="Code defined by a terminology system" />
      <definition value="A reference to a code defined by a terminology system." />
      <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." />
      <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="CodeableConcept.coding" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="C*E.1-8, C*E.10-22" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="union(., ./translation)" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
      </mapping>
    </element>
    <element id="MessageDefinition.jurisdiction.coding.id">
      <path value="MessageDefinition.jurisdiction.coding.id" />
      <representation value="xmlAttr" />
      <short value="xml:id (or equivalent in JSON)" />
      <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <comment value="Note that FHIR strings may not exceed 1MB in size" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.jurisdiction.coding.extension">
      <path value="MessageDefinition.jurisdiction.coding.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. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <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>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="MessageDefinition.jurisdiction.coding.system">
      <path value="MessageDefinition.jurisdiction.coding.system" />
      <short value="Identity of the terminology system" />
      <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
      <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." />
      <requirements value="Need to be unambiguous about the source of the definition of the symbol." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="C*E.3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystem" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
      </mapping>
    </element>
    <element id="MessageDefinition.jurisdiction.coding.version">
      <path value="MessageDefinition.jurisdiction.coding.version" />
      <short value="Version of the system - if relevant" />
      <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
      <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.version" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="C*E.7" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystemVersion" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
      </mapping>
    </element>
    <element id="MessageDefinition.jurisdiction.coding.code">
      <path value="MessageDefinition.jurisdiction.coding.code" />
      <short value="Symbol in syntax defined by the system" />
      <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." />
      <comment value="Note that FHIR strings may not exceed 1MB in size" />
      <requirements value="Need to refer to a particular code in the system." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.code" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="C*E.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./code" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
      </mapping>
    </element>
    <element id="MessageDefinition.jurisdiction.coding.display">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true" />
      </extension>
      <path value="MessageDefinition.jurisdiction.coding.display" />
      <short value="Representation defined by the system" />
      <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
      <comment value="Note that FHIR strings may not exceed 1MB in size" />
      <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="C*E.2 - but note this is not well followed" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV.displayName" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
      </mapping>
    </element>
    <element id="MessageDefinition.jurisdiction.coding.userSelected">
      <path value="MessageDefinition.jurisdiction.coding.userSelected" />
      <short value="If this coding was chosen directly by the user" />
      <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." />
      <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." />
      <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.userSelected" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="Sometimes implied by being first" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD.codingRationale" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
      </mapping>
    </element>
    <element id="MessageDefinition.jurisdiction.text">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true" />
      </extension>
      <path value="MessageDefinition.jurisdiction.text" />
      <short value="Plain text representation of the concept" />
      <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." />
      <comment value="Very often the text is the same as a displayName of one of the codings." />
      <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="CodeableConcept.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="C*E.9. But note many systems use C*E.2 for this" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
      </mapping>
    </element>
    <element id="MessageDefinition.purpose">
      <path value="MessageDefinition.purpose" />
      <short value="Why this message definition is defined" />
      <definition value="Explaination of why this message definition is needed and why it has been designed as it has." />
      <comment value="This element does not describe the usage of the message definition Instead  it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is.  This may be used to point to source materials or specifications that drove the structure of this message definition." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.purpose" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="markdown" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="objimpl" />
        <map value="no-gen-base" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="why" />
      </mapping>
    </element>
    <element id="MessageDefinition.copyright">
      <path value="MessageDefinition.copyright" />
      <short value="Use and/or publishing restrictions" />
      <definition value="A copyright statement relating to the message definition and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the message definition." />
      <comment value="Systems are not required to have markdown support, and there is considerable variation in markdown syntax, so the text should be readable without markdown processing. The preferred markdown syntax is described here: http://daringfireball.net/projects/markdown/syntax (and tests here: http://daringfireball.net/projects/downloads/MarkdownTest_1.0.zip)" />
      <requirements value="Consumers must be able to determine any legal restrictions on the use of the message definition and/or its content." />
      <alias value="License" />
      <alias value="Restrictions" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.copyright" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="markdown" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="objimpl" />
        <map value="no-gen-base" />
      </mapping>
    </element>
    <element id="MessageDefinition.base">
      <path value="MessageDefinition.base" />
      <short value="Definition this one is based on" />
      <definition value="The MessageDefinition that is the basis for the contents of this resource." />
      <comment value="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." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.base" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Canonical" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MessageDefinition" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </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.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
      </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="workflow" />
        <map value="MessageDefinition.base" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="Varies by domain" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=DEFN].target" />
      </mapping>
    </element>
    <element id="MessageDefinition.parent">
      <path value="MessageDefinition.parent" />
      <short value="Protocol/workflow this is part of" />
      <definition value="Identifies a protocol or workflow that this MessageDefinition represents a step in." />
      <comment value="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." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MessageDefinition.parent" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Canonical" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ActivityDefinition" />
      </type>
      <type>
        <code value="Canonical" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PlanDefinition" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </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.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
      </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="workflow" />
        <map value="MessageDefinition.parent" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="Varies by domain" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=DEFN].target" />
      </mapping>
    </element>
    <element id="MessageDefinition.replaces">
      <path value="MessageDefinition.replaces" />
      <short value="Takes the place of" />
      <definition value="A MessageDefinition that is superseded by this definition." />
      <comment value="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." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MessageDefinition.replaces" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Canonical" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MessageDefinition" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </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.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
      </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="workflow" />
        <map value="Request.replaces" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="Varies by domain" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=DEFN].target" />
      </mapping>
    </element>
    <element id="MessageDefinition.event">
      <path value="MessageDefinition.event" />
      <short value="Event type" />
      <definition value="A coded identifier of a supported messaging event." />
      <comment value="Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.event" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <fixedCoding>
        <system value="TBD" />
        <code value="GEL0001" />
        <display value="Application Acknowledgement" />
        <userSelected value="false" />
      </fixedCoding>
      <type>
        <code value="uri" />
        <profile value="http://hl7.org/fhir/StructureDefinition/uri" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MessageEvent" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true" />
        </extension>
        <strength value="example" />
        <description value="One of the message events defined as part of FHIR." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/message-events" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
      </mapping>
    </element>
    <element id="MessageDefinition.category">
      <path value="MessageDefinition.category" />
      <short value="Consequence | Currency | Notification" />
      <definition value="The impact of the content of the message." />
      <comment value="Note that FHIR strings may not exceed 1MB in size" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.category" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MessageSignificanceCategory" />
        </extension>
        <strength value="required" />
        <description value="The impact of the content of a message." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/message-significance-category|4.0.0" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.focus">
      <path value="MessageDefinition.focus" />
      <short value="Resource(s) that are the subject of the event" />
      <definition value="Identifies the resource (or resources) that are being addressed by the event.  For example, the Encounter for an admit message or two Account records for a merge." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MessageDefinition.focus" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="md-1" />
        <severity value="error" />
        <human value="Max must be postive int or *" />
        <expression value="max='*' or (max.toInteger() &gt; 0)" />
        <xpath value="f:max/@value='*' or number(f:max/@value) &gt; 0" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.focus.id">
      <path value="MessageDefinition.focus.id" />
      <representation value="xmlAttr" />
      <short value="xml:id (or equivalent in JSON)" />
      <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <comment value="Note that FHIR strings may not exceed 1MB in size" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.focus.extension">
      <path value="MessageDefinition.focus.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. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <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>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="MessageDefinition.focus.modifierExtension">
      <path value="MessageDefinition.focus.modifierExtension" />
      <short value="Extensions that cannot be ignored" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." />
      <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" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="BackboneElement.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
      </constraint>
      <isModifier value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="MessageDefinition.focus.code">
      <path value="MessageDefinition.focus.code" />
      <short value="Type of resource" />
      <definition value="The kind of resource that must be the focus for this message." />
      <comment value="Multiple focuses addressing different resources may occasionally occur.  E.g. to link or unlink a resource from a particular account or encounter, etc." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.focus.code" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ResourceType" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true" />
        </extension>
        <strength value="required" />
        <description value="One of the resource types defined as part of FHIR." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/resource-types|4.0.0" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.focus.profile">
      <path value="MessageDefinition.focus.profile" />
      <short value="Profile that must be adhered to by focus" />
      <definition value="A profile that reflects constraints for the focal resource (and potentially for related resources)." />
      <comment value="This should be present for most message definitions.  However, if the message focus is only a single resource and there is no need to include referenced resources or otherwise enforce the presence of particular elements, it can be omitted." />
      <requirements value="This profile allows setting boundaries for what content must appear within the message bundle vs. outside based on the declared aggregation constraints on referenced resources on this and related profiles." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.focus.profile" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Canonical" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/StructureDefinition" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </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.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
      </constraint>
      <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="MessageDefinition.focus.profile" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="Varies by domain" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=DEFN].target" />
      </mapping>
    </element>
    <element id="MessageDefinition.focus.min">
      <path value="MessageDefinition.focus.min" />
      <short value="Minimum number of focuses of this type" />
      <definition value="Identifies the minimum number of resources of this type that must be pointed to by a message in order for it to be valid against this MessageDefinition." />
      <comment value="32 bit number; for values larger than this, use decimal" />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.focus.min" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="unsignedInt" />
      </type>
      <defaultValueUnsignedInt value="0" />
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.focus.max">
      <path value="MessageDefinition.focus.max" />
      <short value="Maximum number of focuses of this type" />
      <definition value="Identifies the maximum number of resources of this type that must be pointed to by a message in order for it to be valid against this MessageDefinition." />
      <comment value="Note that FHIR strings may not exceed 1MB in size" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.focus.max" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <condition value="md-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.responseRequired">
      <path value="MessageDefinition.responseRequired" />
      <short value="Is a response required?" />
      <definition value="Indicates whether a response is required for this message." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.responseRequired" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
        <profile value="http://hl7.org/fhir/StructureDefinition/code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.allowedResponse">
      <path value="MessageDefinition.allowedResponse" />
      <short value="Responses to this message" />
      <definition value="Indicates what types of messages may be sent as an application-level response to this message." />
      <comment value="This indicates an application level response to &quot;close&quot; a transaction implicit in a particular request message.  To define a complete workflow scenario, look to the [[PlanDefinition]] resource which allows the definition of complex orchestrations, conditionality, etc." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MessageDefinition.allowedResponse" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.allowedResponse.id">
      <path value="MessageDefinition.allowedResponse.id" />
      <representation value="xmlAttr" />
      <short value="xml:id (or equivalent in JSON)" />
      <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <comment value="Note that FHIR strings may not exceed 1MB in size" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.allowedResponse.extension">
      <path value="MessageDefinition.allowedResponse.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. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <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>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="MessageDefinition.allowedResponse.modifierExtension">
      <path value="MessageDefinition.allowedResponse.modifierExtension" />
      <short value="Extensions that cannot be ignored" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." />
      <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" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="BackboneElement.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
      </constraint>
      <isModifier value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="MessageDefinition.allowedResponse.message">
      <path value="MessageDefinition.allowedResponse.message" />
      <short value="Reference to allowed message definition response" />
      <definition value="A reference to the message definition that must be adhered to by this supported response." />
      <comment value="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." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.allowedResponse.message" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="Canonical" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MessageDefinition" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </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.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
      </constraint>
      <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="MessageDefinition.allowedResponse.Message" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="Varies by domain" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=DEFN].target" />
      </mapping>
    </element>
    <element id="MessageDefinition.allowedResponse.situation">
      <path value="MessageDefinition.allowedResponse.situation" />
      <short value="When should this response be used" />
      <definition value="Provides a description of the circumstances in which this response should be used (as opposed to one of the alternative responses)." />
      <comment value="Systems are not required to have markdown support, and there is considerable variation in markdown syntax, so the text should be readable without markdown processing. The preferred markdown syntax is described here: http://daringfireball.net/projects/markdown/syntax (and tests here: http://daringfireball.net/projects/downloads/MarkdownTest_1.0.zip)" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MessageDefinition.allowedResponse.situation" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="markdown" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MessageDefinition.graph">
      <path value="MessageDefinition.graph" />
      <short value="Canonical reference to a GraphDefinition" />
      <definition value="Provides a description of the circumstances in which this response should be used (as opposed to one of the alternative responses)." />
      <comment value="Systems are not required to have markdown support, and there is considerable variation in markdown syntax, so the text should be readable without markdown processing. The preferred markdown syntax is described here: http://daringfireball.net/projects/markdown/syntax (and tests here: http://daringfireball.net/projects/downloads/MarkdownTest_1.0.zip)" />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="Canonical" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/GraphDefinition" />
      </type>
      <mapping>
        <identity value="workflow" />
        <map value="MessageDefinition.graph" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="Varies by domain" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=DEFN].target" />
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="MessageDefinition.identifier">
      <path value="MessageDefinition.identifier" />
      <max value="*" />
    </element>
    <element id="MessageDefinition.status">
      <path value="MessageDefinition.status" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="PublicationStatus" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true" />
        </extension>
        <strength value="required" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/publication-status|4.0.0" />
        </valueSetReference>
      </binding>
    </element>
    <element id="MessageDefinition.base">
      <path value="MessageDefinition.base" />
      <type>
        <code value="Canonical" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MessageDefinition" />
      </type>
      <mapping>
        <identity value="workflow" />
        <map value="MessageDefinition.base" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="Varies by domain" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=DEFN].target" />
      </mapping>
    </element>
    <element id="MessageDefinition.parent">
      <path value="MessageDefinition.parent" />
      <type>
        <code value="Canonical" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ActivityDefinition" />
      </type>
      <type>
        <code value="Canonical" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PlanDefinition" />
      </type>
      <mapping>
        <identity value="workflow" />
        <map value="MessageDefinition.parent" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="Varies by domain" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=DEFN].target" />
      </mapping>
    </element>
    <element id="MessageDefinition.replaces">
      <path value="MessageDefinition.replaces" />
      <type>
        <code value="Canonical" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MessageDefinition" />
      </type>
      <mapping>
        <identity value="workflow" />
        <map value="Request.replaces" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="Varies by domain" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=DEFN].target" />
      </mapping>
    </element>
    <element id="MessageDefinition.event">
      <path value="MessageDefinition.event" />
      <type>
        <code value="Coding" />
      </type>
      <type>
        <code value="uri" />
        <profile value="http://hl7.org/fhir/StructureDefinition/uri" />
      </type>
    </element>
    <element id="MessageDefinition.category">
      <path value="MessageDefinition.category" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MessageSignificanceCategory" />
        </extension>
        <strength value="required" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/message-significance-category|4.0.0" />
        </valueSetReference>
      </binding>
    </element>
    <element id="MessageDefinition.focus.code">
      <path value="MessageDefinition.focus.code" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ResourceType" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true" />
        </extension>
        <strength value="required" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/resource-types|4.0.0" />
        </valueSetReference>
      </binding>
    </element>
    <element id="MessageDefinition.focus.profile">
      <path value="MessageDefinition.focus.profile" />
      <type>
        <code value="Canonical" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/StructureDefinition" />
      </type>
      <mapping>
        <identity value="workflow" />
        <map value="MessageDefinition.focus.profile" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="Varies by domain" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=DEFN].target" />
      </mapping>
    </element>
    <element id="MessageDefinition.focus.min">
      <path value="MessageDefinition.focus.min" />
      <min value="1" />
    </element>
    <element id="MessageDefinition.responseRequired">
      <path value="MessageDefinition.responseRequired" />
      <type>
        <code value="code" />
        <profile value="http://hl7.org/fhir/StructureDefinition/code" />
      </type>
    </element>
    <element id="MessageDefinition.allowedResponse.message">
      <path value="MessageDefinition.allowedResponse.message" />
      <type>
        <code value="Canonical" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MessageDefinition" />
      </type>
      <mapping>
        <identity value="workflow" />
        <map value="MessageDefinition.allowedResponse.Message" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="Varies by domain" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=DEFN].target" />
      </mapping>
    </element>
  </differential>
</StructureDefinition>