Release 4 FHIR CI-Build

This page is part of the Continuous Integration Build of FHIR Specification (v4.0.1: R4 - Mixed Normative and STU ) in it's permanent home (it will always (will be available incorrect/inconsistent at this URL). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see times).
See the Directory of published versions . Page versions: R5 R4B R4 R3

Linkage.profile.xml

Example StructureDefinition/Linkage (XML)

Maturity Level : N/A
Responsible Owner: Patient Care Work Group Standards Status : Informative Compartments : Practitioner

Raw XML ( canonical form + also see XML Format Specification )

Jump past Narrative

StructureDefinition for linkage

<?xml version="1.0" encoding="UTF-8"?>


  
  
    
  
  
    
    
      
        
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
            
          
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
            
          
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
            
          
          
            
          
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
            
            
              
                
              
            
          
        
        
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
          goAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgC
          sPVYVAgIJrA/sAAAAASUVORK5CYII=)
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw
            NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAACXBIWXMAAAsTAAALEwEAmpwYAAACC
            ElEQVQ4y4XTv2sUQRTA8e9Mzt3kjoOLSXFgZ6GJQlALCysLC89OsLTXv0VFxE4stRAEQUghSWEXuM4qMZpATsUD70dyMdnduZ15z2
            IvMV5IfDDNm5nPm59GVTkpms1mTVXvhxDuichlEZn03m+KyJL3/mWj0fiKqp7YVlZWXrfbbR2PTqeji4uLn1WVEqdECKFRr9eP5Wd
            nZ/HeXwROB0TEA3S7XarVKiLC1tYW8/PzeO/5LxBCUABrLXEc02q1KJfLB30F0P144dPU9LVL1kwcrU06WP0ewhML4JwDYDgcHo7I
            87wAjNq5ypU3Z8arT8F5u/xejw52zmGM+Rcg1wyIcc/BTYCdBlODyh3ElA1AHMekaUoURURRBECWZSNgaGzBxxAU9jfQ9jrJr2dcb
            bXobRYHlQAzo9X1gDR9+KUArE6CwLefZD9WCW6P0uRZKreXqADkHXZ3dshzjwRholJH397AOXcTwHTfzQ1n7q6NnYEAy+DWQVNwKW
            QJ6vcx557Se7HAzIN1M9rCwVteA/rAYDRRICQgSZEr7WLYO3bzJVJGQBu0D74PkoHkoBnIHvjfkO9AGABmDHCjFWgH8i7kPQh9yEe
            YH4DfLhBJgA2A7BBQJ9uwXWY3rhJqFo1AaiB1CBngwKZQcqAeSFSduL9Akj7qPF64jnALS5VTPwdgPwwJ+uog9Qcx4kRZiPKqxgAA
            AABJRU5ErkJggg== 
            Linkage : Identifies two or more records (resource instances) that refer to the same real-world
             &quot;occurrence&quot;.
            
          
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
            
            
            padding-left: 3px; padding-right: 3px; border: 1px grey solid; font-weight: bold; color:
             black; background-color: #fff5e6
          
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
            
          
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4pxLinks records for 'same' item
            
            
            Elements defined in Ancestors: 
            The logical id of the resource, as used in the URL for the resource. Once assigned, this
             value never changes., 

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="Linkage"/> 
  <meta> 
    <lastUpdated value="2025-11-08T11:23:29.301+00:00"/> 
  </meta> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
      <table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align:
       top;">
        <tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align:

         top">
          <th class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom:
           3px">
            <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a>           </th>           <th class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom:
           3px">
            <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a>           </th>           <th class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom:
           3px">
            <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the element can appear in the instance">Card.</a>           </th>           <th class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom:
           3px; width: 100px">
            <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a>           </th>           <th class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom:
           3px">
            <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description &amp; Constraints</a>             <span style="float: right">              <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format">                <img alt="doco" src="data:(snipped in html view)" style="background-color: inherit"/>               </a>             </span>           </th>         </tr>         <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:

         white">
          <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAJUlEQVR4Xu3IIQEAAAg
          DsHd9/w4EQIOamFnaBgAA4MMKAACAKwNp30CqZFfFmwAAAABJRU5ErkJggg==)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Resource"/>              <span title="Linkage : Identifies two or more records (resource instances) that refer to the

             same real-world &quot;occurrence&quot;.">Linkage</span> 
            <a name="Linkage"> </a>           </td>           <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="versions.html#std-process" style="padding-left: 3px; padding-right: 3px; border: 1px grey solid; font-weight: bold;

             color: black; background-color: #efefef; padding-left: 3px; padding-right: 3px;
             border: 1px grey solid; font-weight: bold; color: black; background-color: #efefef" title="Standards Status = Draft">D</a> 
          </td>           <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="domainresource.html">DomainResource</a>           </td>           <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Links records for 'same' item
            <br/>              <span style="font-style: italic" title="lnk-1">+ Rule: Must have at least two items</span>             <br/>              <br/>  Elements defined in Ancestors:             <a href="resource.html#Resource" title="The logical id of the resource, as used in the URL for the resource. Once assigned,

             this value never changes.">id</a> , 

            <a href="resource.html#Resource" title="The metadata about the resource. This is content that is maintained by the infrastructure.
             Changes to the content might not always be associated with version changes to the resource., 
            A reference to a set of rules that were followed when the resource was constructed, and
             which must be understood when processing the content. Often, this is a reference to an
             implementation guide that defines the special rules along with other profiles etc., 
            , 
            A human-readable narrative that contains a summary of the resource and can be used to
             represent the content of the resource to a human. The narrative need not encode all the
             structured data, but is required to contain sufficient detail to make it &quot;clinically
             safe&quot; for a human to just read the narrative. Resource definitions may define what
             content should be represented in the narrative to ensure clinical safety., 
            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., 

             Changes to the content might not always be associated with version changes to the
             resource.">meta</a> , 
            <a href="resource.html#Resource" title="A reference to a set of rules that were followed when the resource was constructed,

             and which must be understood when processing the content. Often, this is a reference
             to an implementation guide that defines the special rules along with other profiles
             etc. For DomainResources, if more than one implicitRules policy applies, additional
             policies may be conveyed using the [additionalImplicitRules](https://build.fhir.org/ig/HL7/fh
            ir-extensions/StructureDefinition-additionalImplicitRules.html) extension.">implicitRules</a> , 
            <a href="resource.html#Resource" title="The base language in which the resource is written.">language</a> ,             <a href="domainresource.html#DomainResource" title="A human-readable narrative that contains a summary of the resource and can be used

             to represent the content of the resource to a human. The narrative need not encode
             all the structured data, but is required to contain sufficient detail to make it
             &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions
             may define what content should be represented in the narrative to ensure clinical
             safety.">text</a> , 
            <a href="domainresource.html#DomainResource" title="These resources do not have an independent existence apart from the resource that

             contains them - they cannot be identified independently, nor can they have their
             own independent transaction scope. This is allowed to be a Parameters resource
             if and only if it is referenced by a resource that provides context/meaning.">contained</a> , 

            <a href="domainresource.html#DomainResource" title="May be used to represent additional information that is not part of the basic definition
             of the resource. To make the use of extensions safe and manageable, there is a strict
             set of governance  applied to the definition and use of extensions. Though any implementer
             can define an extension, there is a set of requirements that SHALL be met as part of the
             definition of the extension., 

             of the resource. To make the use of extensions safe and managable, there is a strict
             set of governance applied to the definition and use of extensions. Though any implementer
             can define an extension, there is a set of requirements that SHALL be met as part
             of the definition of the extension.">extension</a> , 

            <a href="domainresource.html#DomainResource" title="May be used to represent additional information that is not part of the basic definition
             of the resource and that modifies the understanding of the element that contains it and/or
             the understanding of the containing element's descendants. Usually modifier elements provide
             negation or qualification. To make the use of extensions safe and 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
             (including cannot change the meaning of modifierExtension itself).
          
        

        
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iV
          BORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6
          EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5CYII=)
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw
            NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav
            7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAR
            klEQVQ4y2P8//8/AyWAhYFCMAgMuHjx4n+KXaCv+I0szW8WpCG8kFO1lGFKW/SIjAUYgxz/MzAwMDC+nqhDUTQyjuYFBgCNmhP4Ov
            TRgwAAAABJRU5ErkJggg== 
            Linkage.active : Indicates whether the asserted set of linkages are considered to be &quot;in
             effect&quot;.
            
          
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px
            
          
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px
            
          
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px
        

        
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
          goAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgC
          sPVYVAgIJrA/sAAAAASUVORK5CYII=)
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw
            NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav
            7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj
            wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE
            EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ
            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC 
            Linkage.author : Identifies the user or organization responsible for asserting the linkages
             as well as the user or organization who establishes the context in which the nature of
             each linkage is evaluated.
            
          
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
            
          
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
            (
             | 
             | 
            )
          
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
        

        
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iV
          BORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAI0lEQVR42u3QIQEAAAACIL/6/4MvTAQOkLYBAAB4kAAAANwMad9AqkR
          jgNAAAAAASUVORK5CYII=)
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw
            NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO
            L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC
            data: image/png;base64,R0lGODlhEAAQAPQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw
            /npofbjquvNefHVduuyN+uuMu3Oafbgjfnqvf/3zv/3xevPi+vRjP/20/bmsP///wD/ACH5BAEKAB8ALAAAAAAQABAAAAVl4CeOZG
            me5qCqqDg8jyVJaz1876DsmAQAgqDgltspMEhMJoMZ4iy6I1AooFCIv+wKybziALVAoAEjYLwDgGIpJhMslgxaLR4/3rMAWoBp32V
            5exg8Shl1ckRUQVaMVkQ2kCstKCEAOw== 
            Linkage.item : Identifies which record considered as the reference to the same real-world
             occurrence as well as how the items should be evaluated within the collection of linked
             items.
            
          
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px
            
            
          
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px
            
          
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4pxItem to be linked
            
          
        

        
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
          goAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR42u3QwQkAMAwDsezq/WdIO4XJQwa9DTdJpulv258AAMANIgAAADUPYA
          VAgAJ//usAAAAASUVORK5CYII=)
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw
            NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY
            FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav
            7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAR
            klEQVQ4y2P8//8/AyWAhYFCMAgMuHjx4n+KXaCv+I0szW8WpCG8kFO1lGFKW/SIjAUYgxz/MzAwMDC+nqhDUTQyjuYFBgCNmhP4Ov
            TRgwAAAABJRU5ErkJggg== 
            Linkage.item.type : Distinguishes which item is &quot;source of truth&quot; (if any) and
             which items are no longer considered to be current representations.
            
          
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
            
          
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
            
          
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4pxsource | alternate | historical
            
             (
            )
          
        

        
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iV
          BORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAI0lEQVR42u3QIQEAAAACIL/6/4MvTAQOkLYBAAB4kAAAANwMad9AqkR
          jgNAAAAAASUVORK5CYII=)
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw
            NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY
            FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO
            L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj
            wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE
            EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ
            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC 
            
            
          
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px
            
          
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px
            (
            )
          
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px
        

        
          
            
            
               Documentation for this format
            
          
        
      
    
  
  
    
  
  
    
  
  
    
  
  
    
  
  
    
  
  
  
  
  
  
  
  
    
      
      
    
  
  
    
      
      
    
  

             of the resource and that modifies the understanding of the element that contains
             it and/or the understanding of the containing element's descendants. Usually modifier
             elements provide negation or qualification. To make the use of extensions safe
             and managable, there is a strict set of governance applied to the definition and
             use of extensions. Though any implementer is allowed to define an extension, there
             is a set of requirements that SHALL be met as part of the definition of the extension.
             Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or
             DomainResource (including cannot change the meaning of modifierExtension itself).">modifierExtension</a> 
          </td>         </tr>         <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:

         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
          EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/>              <span title="Linkage.active : Indicates whether the asserted set of linkages are considered

             to be &quot;in effect&quot;.">active</span> 
            <a name="Linkage.active"> </a>           </td>           <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:

             3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td>           <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#boolean">boolean</a>           </td>           <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Whether this linkage assertion is active or not
            <br/>            </td>         </tr>         <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:

         white">
          <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
          EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>              <span title="Linkage.author : Identifies the user or organization responsible for asserting

             the linkages and establishing the context in which the nature of each linkage is
             evaluated.">author</span> 
            <a name="Linkage.author"> </a>           </td>           <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:

             3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td>           <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (            <a href="practitioner.html">Practitioner</a>  |             <a href="practitionerrole.html">PractitionerRole</a>  |             <a href="organization.html">Organization</a> )          </td>           <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Who is responsible for linkages
            <br/>            </td>         </tr>         <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:

         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAJUlEQVR4Xu3IIQEAAAg
          DsHd9/w4EQIOamFnaBgAA4MMKAACAKwNp30CqZFfFmwAAAABJRU5ErkJggg==)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Element"/>              <span title="Linkage.item : Identifies a member of a set of resource instances considered to

             refer to the same real-world entity and classifies the role of the resource instance
             in the set.">item</span> 
            <a name="Linkage.item"> </a>           </td>           <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:

             3px; color: black; null" title="This element is included in summaries">Σ</a> 
            <a href="conformance-rules.html#constraints" style="padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold;

             color: #301212; background-color: #fdf4f4;; padding-left: 3px; padding-right: 3px;
             border: 1px maroon solid; font-weight: bold; color: #301212; background-color:
             #fdf4f4;" title="This element has or is affected by some invariants">C</a> 
          </td>           <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">1..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="types.html#BackBoneElement">BackboneElement</a>           </td>           <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Item to be linked
            <br/>              <br/>            </td>         </tr>         <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:

         white">
          <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAw
          Esez6+89AqKGGJj7JzVWS+mm3zgcAAMxwDQAAgFcaYAVAgNGLTjgAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Primitive Data Type"/>              <span title="Linkage.item.type : Distinguishes which item is &quot;source of truth&quot; (if

             any) and which items are no longer considered to be current representations.">type</span> 
            <a name="Linkage.item.type"> </a>           </td>           <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:

             3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td>           <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#code">code</a>           </td>           <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">source | alternate | historical
            <br/>  Binding:             <a href="valueset-linkage-type.html">Linkage Type</a>  (            <a href="terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value

             set.">Required</a> )
            <br/>            </td>         </tr>         <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:

         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAJUlEQVR4Xu3IIQEAAAg
          DsHd9/w4EQIOamFnaBgAA4MMKAACAKwNp30CqZFfFmwAAAABJRU5ErkJggg==)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/>             <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource"/>              <span title="Linkage.item.resource : The resource instance being linked as part of the group.">resource</span>             <a name="Linkage.item.resource"> </a>           </td>           <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:

             3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td>           <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (            <a href="resourcelist.html">Any</a> )          </td>           <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;

           border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Resource being linked
            <br/>            </td>         </tr>         <tr>           <td class="hierarchy" colspan="5">            <br/>              <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format">              <img alt="doco" src="data:(snipped in html view)" style="background-color: inherit"/>  Documentation for this format            </a>           </td>         </tr>       </table>     </div>   </text>   <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">    <valueCode value="draft"/>   </extension>   <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">    <valueCode value="pc"/>   </extension>   <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">    <valueInteger value="0"/>   </extension>   <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category">    <valueCode value="patient"/>   </extension>   <url value="http://hl7.org/fhir/StructureDefinition/Linkage"/>   <version value="6.0.0-ballot3"/>   <name value="Linkage"/>   <status value="draft"/>   <experimental value="false"/>   <date value="2025-11-08T11:23:29+00:00"/>   <publisher value="HL7 International / Patient Care"/>   <contact>     <telecom>       <system value="url"/>       <value value="http://www.hl7.org/Special/committees/fiwg"/>     </telecom>   </contact>   <contact>     <telecom>       <system value="url"/>       <value value="http://www.hl7.org/Special/committees/patientcare"/>     </telecom>   </contact> 
  <description value="Identifies two or more records (resource instances) that refer to the same real-world
   &quot;occurrence&quot;.
  
  
    
    
    
  
  
    
    
    
  
  
  
  
  
  
  
    
      
      

   &quot;occurrence&quot;."/> 
  <jurisdiction>     <coding>       <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>       <code value="001"/>       <display value="World"/>     </coding>   </jurisdiction>   <fhirVersion value="6.0.0-ballot3"/>   <mapping>     <identity value="w5"/>     <uri value="http://hl7.org/fhir/fivews"/>     <name value="FiveWs Pattern Mapping"/>   </mapping>   <mapping>     <identity value="rim"/>     <uri value="http://hl7.org/v3"/>     <name value="RIM Mapping"/>   </mapping>   <kind value="resource"/>   <abstract value="false"/>   <type value="Linkage"/>   <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>   <derivation value="specialization"/>   <snapshot>     <element id="Linkage">      <path value="Linkage"/>       <short value="Links records for 'same' item"/> 
      <definition value="Identifies two or more records (resource instances) that refer to the same real-world
       &quot;occurrence&quot;.
      
      
      
        
        
        
      
      
        
        
        
        
        
        
      
      
        
        
        If the resource is contained in another resource, it SHALL be referred to from elsewhere
         in the resource or SHALL refer to the containing resource
        contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonica
        l) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(refer
        ence = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(c
        anonical) = '#').exists()).not()).trace('unmatched', id).empty()
        not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:refere
        nce/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
        
      
      
        
        
        If a resource is contained in another resource, it SHALL NOT have a meta.versionId or
         a meta.lastUpdated
        
        
        
      
      
        
        
        
        
        
        
      
      
        
          
        
        
          When a resource has no narrative, only systems that fully understand the data can display
           the resource to a human safely. Including a human readable representation in the resource
           makes for a much more robust eco-system and cheaper handling of resources by intermediary
           systems. Some ecosystems restrict distribution of resources to only those systems that
           do fully understand the resources, and as a consequence implementers may believe that
           the narrative is superfluous. However experience shows that such eco-systems often open
           up to new participants over time.
        
        
        
        
        
        
        
      
      
        
        
        
        
        
      
      
      
      
        
        
      
      
        
        
      
    
    
      
      
      The logical id of the resource, as used in the URL for the resource. Once assigned, this
       value never changes.
      The only time that a resource does not have an id is when it is being submitted to the
       server using a create operation.
      
      
      
        
        
        
      
    <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler magic
       (j)  -->
      
        
          
        
        
      
      
      
    
    
      
      

       &quot;occurrence&quot;."/> 
      <min value="0"/>       <max value="*"/>       <base>         <path value="Linkage"/>         <min value="0"/>         <max value="*"/>       </base>       <constraint>         <key value="dom-2"/>         <severity value="error"/>         <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>         <expression value="contained.contained.empty()"/>         <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>       </constraint>       <constraint>         <key value="dom-3"/>         <severity value="error"/>         <human value="If the resource is contained in another resource, it SHALL be referred to from

         elsewhere in the resource or SHALL refer to the containing resource"/> 
        <expression value="contained.where((('#'+id.trace('id') in %resource.descendants().select(reference

         | as(uri))) or descendants().where(reference='#' | as(uri)='#').exists()).not()).trace('unmat
        ched', id).empty()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>       </constraint>       <constraint>         <key value="dom-4"/>         <severity value="error"/>         <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId

         or a meta.lastUpdated"/> 
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>         <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>       </constraint>       <constraint>         <key value="dom-5"/>         <severity value="error"/>         <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/>         <expression value="contained.meta.security.empty()"/>         <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>       </constraint>       <constraint>         <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">          <valueBoolean value="true"/>         </extension>         <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">          <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can

           display the resource to a human safely. Including a human readable representation
           in the resource makes for a much more robust eco-system and cheaper handling of
           resources by intermediary systems. Some ecosystems restrict distribution of resources
           to only those systems that do fully understand the resources, and as a consequence
           implementers may believe that the narrative is superfluous. However experience
           shows that such eco-systems often open up to new participants over time."/> 
        </extension>         <key value="dom-6"/>         <severity value="warning"/>         <human value="A resource should have narrative for robust management"/>         <expression value="text.`div`.exists()"/>         <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>       </constraint>       <constraint>         <key value="lnk-1"/>         <severity value="error"/>         <human value="Must have at least two items"/>         <expression value="item.count()&gt;1"/>         <source value="http://hl7.org/fhir/StructureDefinition/Linkage"/>       </constraint>       <mustSupport value="false"/>       <isModifier value="false"/>       <isSummary value="false"/>       <mapping>         <identity value="rim"/>         <map value="Entity, Role, or Act,N/A - RIM doesn't know how to do this"/>       </mapping>       <mapping>         <identity value="w5"/>         <map value="infrastructure.structure"/>       </mapping>     </element>     <element id="Linkage.id">      <path value="Linkage.id"/>       <short value="Logical id of this artifact"/>       <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned,

       this value never changes."/> 
      <comment value="Within the context of the FHIR RESTful interactions, the resource has an id except

       for cases like the create and conditional update. Otherwise, the use of the resouce
       id depends on the given use case."/> 
      <min value="0"/>       <max value="1"/>       <base>         <path value="Resource.id"/>         <min value="0"/>         <max value="1"/>       </base>       <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler

       magic (j)  -->
      <type>         <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">          <valueUrl value="string"/>         </extension>         <code value="http://hl7.org/fhirpath/System.String"/>       </type>       <mustSupport value="false"/>       <isModifier value="false"/>       <isSummary value="true"/>     </element>     <element id="Linkage.meta">      <path value="Linkage.meta"/>       <short value="Metadata about the resource"/> 
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
       Changes to the content might not always be associated with version changes to the resource.
      
      
      
        
        
        
      
      
        
      
      
        
        
        
        
        
        
      
      
      
    
    
      
      
      A reference to a set of rules that were followed when the resource was constructed, and
       which must be understood when processing the content. Often, this is a reference to an
       implementation guide that defines the special rules along with other profiles etc.
      Asserting this rule set restricts the content to be only understood by a limited set of
       trading partners. This inherently limits the usefulness of the data in the long term.
       However, the existing health eco-system is highly fractured, and not yet ready to define,
       collect, and exchange data in a generally computable sense. Wherever possible, implementers
       and/or specification writers should avoid using this element. Often, when used, the URL
       is a reference to an implementation guide that defines these special rules as part of
       it's narrative along with other profiles, value sets, etc.
      
      
      
        
        
        
      
      
        
      
      
        
        
        
        
        
        
      
      

       Changes to the content might not always be associated with version changes to the
       resource."/> 
      <min value="0"/>       <max value="1"/>       <base>         <path value="Resource.meta"/>         <min value="0"/>         <max value="1"/>       </base>       <type>         <code value="Meta"/>       </type>       <constraint>         <key value="ele-1"/>         <severity value="error"/>         <human value="All FHIR elements must have a @value or children"/>         <expression value="hasValue() or (children().count() &gt; id.count())"/>         <source value="http://hl7.org/fhir/StructureDefinition/Element"/>       </constraint>       <mustSupport value="false"/>       <isModifier value="false"/>       <isSummary value="true"/>     </element>     <element id="Linkage.implicitRules">      <path value="Linkage.implicitRules"/>       <short value="A set of rules under which this content was created"/>       <definition value="A reference to a set of rules that were followed when the resource was constructed,

       and which must be understood when processing the content. Often, this is a reference
       to an implementation guide that defines the special rules along with other profiles
       etc. For DomainResources, if more than one implicitRules policy applies, additional
       policies may be conveyed using the [additionalImplicitRules](https://build.fhir.org/ig/HL7/fh
      ir-extensions/StructureDefinition-additionalImplicitRules.html) extension."/> 
      <comment value="Asserting this rule set restricts the content to be only understood by a limited

       set of trading partners. This inherently limits the usefulness of the data in the
       long term. However, the existing health eco-system is highly fractured, and not
       yet ready to define, collect, and exchange data in a generally computable sense.
       Wherever possible, implementers and/or specification writers should avoid using
       this element. Often, when used, the URL is a reference to an implementation guide
       that defines these special rules as part of its narrative along with other profiles,
       value sets, etc."/> 
      <min value="0"/>       <max value="1"/>       <base>         <path value="Resource.implicitRules"/>         <min value="0"/>         <max value="1"/>       </base>       <type>         <code value="uri"/>       </type>       <constraint>         <key value="ele-1"/>         <severity value="error"/>         <human value="All FHIR elements must have a @value or children"/>         <expression value="hasValue() or (children().count() &gt; id.count())"/>         <source value="http://hl7.org/fhir/StructureDefinition/Element"/>       </constraint>       <mustSupport value="false"/>       <isModifier value="true"/> 
      <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional
       knowledge about the resource that modifies it's meaning or interpretation
      
    
    
      
      
      
      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).
      
      
      
        
        
        
      
      
        
      
      
        
        
        
        
        
        
      
      
      
      
        
          
        
        
          
        
        
          
        
        
        
        
      
    
    
      
      
      A human-readable narrative that contains a summary of the resource and can be used to
       represent the content of the resource to a human. The narrative need not encode all the
       structured data, but is required to contain sufficient detail to make it &quot;clinically
       safe&quot; for a human to just read the narrative. Resource definitions may define what
       content should be represented in the narrative to ensure clinical safety.
      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 information is added
       later.
      
      
      
      
      
      
      
        
        
        
      
      
        
      
      
        
        
        
        
        
        
      
      
      
      
        
        
      
    
    
      
      
      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.
      This should never be done when the content can be identified properly, as once identification
       is lost, it is extremely difficult (and context dependent) to restore it again. Contained
       resources may have profiles and tags In their meta elements, but SHALL NOT have security
       labels.
      
      
      
      
      
      
        
        
        
      
      
        
      
      
      
      
        
        
      
    
    
      
      

       knowledge about the resource that modifies its meaning or interpretation"/> 
      <isSummary value="true"/>     </element>     <element id="Linkage.language">      <path value="Linkage.language"/>       <short value="Language of the resource content"/>       <definition value="The base language in which the resource is written."/>       <comment value="Language is provided to support indexing and accessibility (typically, services

       such as text to speech use the language tag). The html language tag in the narrative
       applies  to the narrative. The language tag on the resource may be used to specify
       the language of other presentations generated from the data in the resource. Not
       all the content has to be in the base language. The Resource.language should not
       be assumed to apply to the narrative automatically. If a language is specified,
       it should it also be specified on the div element in the html (see rules in HTML5
       for information about the relationship between xml:lang and the html lang attribute)."/> 
      <min value="0"/>       <max value="1"/>       <base>         <path value="Resource.language"/>         <min value="0"/>         <max value="1"/>       </base>       <type>         <code value="code"/>       </type>       <constraint>         <key value="ele-1"/>         <severity value="error"/>         <human value="All FHIR elements must have a @value or children"/>         <expression value="hasValue() or (children().count() &gt; id.count())"/>         <source value="http://hl7.org/fhir/StructureDefinition/Element"/>       </constraint>       <mustSupport value="false"/>       <isModifier value="false"/>       <isSummary value="false"/>       <binding>         <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">          <valueString value="Language"/>         </extension>         <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">          <valueBoolean value="true"/>         </extension>         <strength value="required"/>         <description value="IETF language tag for a human language"/>         <valueSet value="http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot3"/>         <additional>           <purpose value="starter"/>           <valueSet value="http://hl7.org/fhir/ValueSet/languages"/>         </additional>       </binding>     </element>     <element id="Linkage.text">      <path value="Linkage.text"/>       <short value="Text summary of the resource, for human interpretation"/>       <definition value="A human-readable narrative that contains a summary of the resource and can be used

       to represent the content of the resource to a human. The narrative need not encode
       all the structured data, but is required to contain sufficient detail to make it
       &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions
       may define what content should be represented in the narrative to ensure clinical
       safety."/> 
      <comment value="Contained resources do not have a narrative. Resources that are not contained SHOULD

       have a narrative. In some cases, a resource may only have text with little or no
       additional discrete data (as long as all minOccurs=1 elements are satisfied). 
       This may be necessary for data from legacy systems where information is captured
       as a &quot;text blob&quot; or where text is additionally entered raw or narrated
       and encoded information is added later."/> 
      <alias value="narrative"/>       <alias value="html"/>       <alias value="xhtml"/>       <alias value="display"/>       <min value="0"/>       <max value="1"/>       <base>         <path value="DomainResource.text"/>         <min value="0"/>         <max value="1"/>       </base>       <type>         <code value="Narrative"/>       </type>       <condition value="dom-6"/>       <constraint>         <key value="ele-1"/>         <severity value="error"/>         <human value="All FHIR elements must have a @value or children"/>         <expression value="hasValue() or (children().count() &gt; id.count())"/>         <source value="http://hl7.org/fhir/StructureDefinition/Element"/>       </constraint>       <mustSupport value="false"/>       <isModifier value="false"/>       <isSummary value="false"/>       <mapping>         <identity value="rim"/>         <map value="Act.text?"/>       </mapping>     </element>     <element id="Linkage.contained">      <path value="Linkage.contained"/>       <short value="Contained, inline Resources"/>       <definition value="These resources do not have an independent existence apart from the resource that

       contains them - they cannot be identified independently, nor can they have their
       own independent transaction scope. This is allowed to be a Parameters resource
       if and only if it is referenced by a resource that provides context/meaning."/> 
      <comment value="This should never be done when the content can be identified properly, as once

       identification is lost, it is extremely difficult (and context dependent) to restore
       it again. Contained resources may have profiles and tags in their meta elements,
       but SHALL NOT have security labels. Contained resources may be a resource type
       defined in the FHIR specification, or an [additional resource](resource.html#additional)."/> 
      <alias value="inline resources"/>       <alias value="anonymous resources"/>       <alias value="contained resources"/>       <min value="0"/>       <max value="*"/>       <base>         <path value="DomainResource.contained"/>         <min value="0"/>         <max value="*"/>       </base>       <type>         <code value="Resource"/>       </type>       <condition value="dom-2"/>       <condition value="dom-4"/>       <condition value="dom-3"/>       <condition value="dom-5"/>       <mustSupport value="false"/>       <isModifier value="false"/>       <isSummary value="false"/>       <mapping>         <identity value="rim"/>         <map value="N/A"/>       </mapping>     </element>     <element id="Linkage.extension">      <path value="Linkage.extension"/>       <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. To make the use of extensions safe and manageable, there is a strict
       set of governance  applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part of the
       definition of the extension.
      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.
      
      
      
      
      
        
        
        
      
      
        
      
      
        
        
        
        
        
        
      
      
        
        
        
        
        
        
      
      
      
      
        
        
      
    
    
      
      

       of the resource. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part
       of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,

       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/>       <alias value="user content"/>       <min value="0"/>       <max value="*"/>       <base>         <path value="DomainResource.extension"/>         <min value="0"/>         <max value="*"/>       </base>       <type>         <code value="Extension"/>       </type>       <constraint>         <key value="ele-1"/>         <severity value="error"/>         <human value="All FHIR elements must have a @value or children"/>         <expression value="hasValue() or (children().count() &gt; id.count())"/>         <source value="http://hl7.org/fhir/StructureDefinition/Element"/>       </constraint>       <mustSupport value="false"/>       <isModifier value="false"/>       <isSummary value="false"/>       <mapping>         <identity value="rim"/>         <map value="N/A"/>       </mapping>     </element>     <element id="Linkage.modifierExtension">      <path value="Linkage.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 resource and that modifies the understanding of the element that contains it and/or
       the understanding of the containing element's descendants. Usually modifier elements provide
       negation or qualification. To make the use of extensions safe and 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
       (including cannot change the meaning of modifierExtension itself).
      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.
      Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly
       distinguished from the vast majority of extensions which can be safely ignored.  This
       promotes interoperability by eliminating the need for implementers to prohibit the presence
       of extensions. For further information, see the [definition of modifier extensions](extensibility.ht
      ml#modifierExtension).
      
      
      
      
      
        
        
        
      
      
        
      
      
        
        
        
        
        
        
      
      
        
        
        
        
        
        
      
      
      Modifier extensions are expected to modify the meaning or interpretation of the resource
       that contains them
      
      
        
        
      
    
    
      
      
      
      
      
      
      
      
        
        
        
      
      
        
      
      This resource is generally assumed to be active if no value is provided for the active
       element
      
        
        
        
        
        
        
      
      
      
      
        
        
      
    
    
      
      
      Identifies the user or organization responsible for asserting the linkages as well as
       the user or organization who establishes the context in which the nature of each linkage
       is evaluated.
      &quot;Primary&quot; for the same set of linked resources may be different from different
       user's/organization's perspectives.
      
      
      
        
        
        
      
      
        
        
        
        
      
      
        
        
        
        
        
        
      
      
      
      
        
        
      
    
    
      
      
      Identifies which record considered as the reference to the same real-world occurrence
       as well as how the items should be evaluated within the collection of linked items.
      
      
      
        
        
        
      
      
        
      
      
      
        
        
        
        
        
        
      
      
      
    
    
      
      
      
      Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces.
      
      
      
        
        
        
      
    <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler magic
       (j)  -->
      
        
          
        
        
      
      
      
      
        
        
      
    
    
      
      

       of the resource and that modifies the understanding of the element that contains
       it and/or the understanding of the containing element's descendants. Usually modifier
       elements provide negation or qualification. To make the use of extensions safe
       and managable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there
       is a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,

       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be

       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/>       <alias value="user content"/>       <min value="0"/>       <max value="*"/>       <base>         <path value="DomainResource.modifierExtension"/>         <min value="0"/>         <max value="*"/>       </base>       <type>         <code value="Extension"/>       </type>       <constraint>         <key value="ele-1"/>         <severity value="error"/>         <human value="All FHIR elements must have a @value or children"/>         <expression value="hasValue() or (children().count() &gt; id.count())"/>         <source value="http://hl7.org/fhir/StructureDefinition/Element"/>       </constraint>       <mustSupport value="false"/>       <isModifier value="true"/>       <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the

       resource that contains them"/> 
      <isSummary value="true"/>       <mapping>         <identity value="rim"/>         <map value="N/A"/>       </mapping>     </element>     <element id="Linkage.active">      <path value="Linkage.active"/>       <short value="Whether this linkage assertion is active or not"/>       <definition value="Indicates whether the asserted set of linkages are considered to be &quot;in effect&quot;."/>       <comment value="If false, any asserted linkages should not be considered current/relevant/applicable."/>       <requirements value="Need to be able to mark a linkage record as not to be used because it was created

       in error."/> 
      <min value="0"/>       <max value="1"/>       <base>         <path value="Linkage.active"/>         <min value="0"/>         <max value="1"/>       </base>       <type>         <code value="boolean"/>       </type>       <meaningWhenMissing value="This resource is generally assumed to be active if no value is provided for the

       active element"/> 
      <constraint>         <key value="ele-1"/>         <severity value="error"/>         <human value="All FHIR elements must have a @value or children"/>         <expression value="hasValue() or (children().count() &gt; id.count())"/>         <source value="http://hl7.org/fhir/StructureDefinition/Element"/>       </constraint>       <mustSupport value="false"/>       <isModifier value="false"/>       <isSummary value="true"/>       <mapping>         <identity value="w5"/>         <map value="FiveWs.status"/>       </mapping>     </element>     <element id="Linkage.author">      <path value="Linkage.author"/>       <short value="Who is responsible for linkages"/>       <definition value="Identifies the user or organization responsible for asserting the linkages and

       establishing the context in which the nature of each linkage is evaluated."/> 
      <min value="0"/>       <max value="1"/>       <base>         <path value="Linkage.author"/>         <min value="0"/>         <max value="1"/>       </base>       <type>         <code value="Reference"/>         <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>         <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>         <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/>       </type>       <constraint>         <key value="ele-1"/>         <severity value="error"/>         <human value="All FHIR elements must have a @value or children"/>         <expression value="hasValue() or (children().count() &gt; id.count())"/>         <source value="http://hl7.org/fhir/StructureDefinition/Element"/>       </constraint>       <mustSupport value="false"/>       <isModifier value="false"/>       <isSummary value="true"/>       <mapping>         <identity value="w5"/>         <map value="FiveWs.author"/>       </mapping>     </element>     <element id="Linkage.item">      <path value="Linkage.item"/>       <short value="Item to be linked"/>       <definition value="Identifies a member of a set of resource instances considered to refer to the same

       real-world entity and classifies the role of the resource instance in the set."/> 
      <min value="1"/>       <max value="*"/>       <base>         <path value="Linkage.item"/>         <min value="1"/>         <max value="*"/>       </base>       <type>         <code value="BackboneElement"/>       </type>       <condition value="lnk-1"/>       <constraint>         <key value="ele-1"/>         <severity value="error"/>         <human value="All FHIR elements must have a @value or children or both"/>         <expression value="hasValue() or (children().count() &gt; id.count())"/>         <source value="http://hl7.org/fhir/StructureDefinition/Element"/>       </constraint>       <mustSupport value="false"/>       <isModifier value="false"/>       <isSummary value="true"/>     </element>     <element id="Linkage.item.id">      <path value="Linkage.item.id"/>       <representation value="xmlAttr"/>       <short value="Unique id for inter-element referencing"/>       <definition value="Unique id for the element within a resource (for internal references). This may

       be any string value that does not contain spaces."/> 
      <min value="0"/>       <max value="1"/>       <base>         <path value="Element.id"/>         <min value="0"/>         <max value="1"/>       </base>       <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler

       magic (j)  -->
      <type>         <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">          <valueUrl value="string"/>         </extension>         <code value="http://hl7.org/fhirpath/System.String"/>       </type>       <condition value="ele-1"/>       <isModifier value="false"/>       <isSummary value="false"/>       <mapping>         <identity value="rim"/>         <map value="n/a"/>       </mapping>     </element>     <element id="Linkage.item.extension">      <path value="Linkage.item.extension"/>       <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and manageable, there is a strict set
       of governance  applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part of the
       definition of the extension.
      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.
      
      
      
      
      
        
        
        
      
      
        
      
      
        
        
        
        
        
        
      
      
        
        
        
        
        
        
      
      
      
      
        
        
      
    
    
      
      

       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part
       of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,

       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/>       <alias value="user content"/>       <min value="0"/>       <max value="*"/>       <base>         <path value="Element.extension"/>         <min value="0"/>         <max value="*"/>       </base>       <type>         <code value="Extension"/>       </type>       <constraint>         <key value="ele-1"/>         <severity value="error"/>         <human value="All FHIR elements must have a @value or children"/>         <expression value="hasValue() or (children().count() &gt; id.count())"/>         <source value="http://hl7.org/fhir/StructureDefinition/Element"/>       </constraint>       <isModifier value="false"/>       <isSummary value="false"/>       <mapping>         <identity value="rim"/>         <map value="n/a"/>       </mapping>     </element>     <element id="Linkage.item.modifierExtension">      <path value="Linkage.item.modifierExtension"/>       <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is contained
       and/or the understanding of the containing element's descendants. Usually modifier elements
       provide negation or qualification. To make the use of extensions safe and manageable,
       there is a strict set of governance applied to the definition and use of extensions. Though
       any implementer can define an extension, there is a set of requirements that SHALL be
       met as part of the definition of the extension. Applications processing a resource are
       required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
       (including cannot change the meaning of modifierExtension itself).
      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.
      Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly
       distinguished from the vast majority of extensions which can be safely ignored.  This
       promotes interoperability by eliminating the need for implementers to prohibit the presence
       of extensions. For further information, see the [definition of modifier extensions](extensibility.ht
      ml#modifierExtension).
      
      
      
      
      
      
        
        
        
      
      
        
      
      
        
        
        
        
        
        
      
      
        
        
        
        
        
        
      
      
      Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them
      
      
        
        
      
    
    
      
      
      Distinguishes which item is &quot;source of truth&quot; (if any) and which items are no
       longer considered to be current representations.
      
      
      
        
        
        
      
      
        
      
      
        
        
        
        
        
        
      
      
      
      
        
          
        
        
        
        
      
    
    
      
      
      
      
      
      
        
        
        
      
      
        
        
      
      
        
        
        
        
        
        
      
      
      
    
  
  
    
      
      

       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,

       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be

       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/>       <alias value="user content"/>       <alias value="modifiers"/>       <min value="0"/>       <max value="*"/>       <base>         <path value="BackboneElement.modifierExtension"/>         <min value="0"/>         <max value="*"/>       </base>       <type>         <code value="Extension"/>       </type>       <constraint>         <key value="ele-1"/>         <severity value="error"/>         <human value="All FHIR elements must have a @value or children"/>         <expression value="hasValue() or (children().count() &gt; id.count())"/>         <source value="http://hl7.org/fhir/StructureDefinition/Element"/>       </constraint>       <isModifier value="true"/>       <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the

       element that contains them"/> 
      <isSummary value="true"/>       <mapping>         <identity value="rim"/>         <map value="N/A"/>       </mapping>     </element>     <element id="Linkage.item.type">      <path value="Linkage.item.type"/>       <short value="source | alternate | historical"/>       <definition value="Distinguishes which item is &quot;source of truth&quot; (if any) and which items

       are no longer considered to be current representations."/> 
      <min value="1"/>       <max value="1"/>       <base>         <path value="Linkage.item.type"/>         <min value="1"/>         <max value="1"/>       </base>       <type>         <code value="code"/>       </type>       <constraint>         <key value="ele-1"/>         <severity value="error"/>         <human value="All FHIR elements must have a @value or children"/>         <expression value="hasValue() or (children().count() &gt; id.count())"/>         <source value="http://hl7.org/fhir/StructureDefinition/Element"/>       </constraint>       <mustSupport value="false"/>       <isModifier value="false"/>       <isSummary value="true"/>       <binding>         <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">          <valueString value="LinkageType"/>         </extension>         <strength value="required"/>         <description value="Used to distinguish different roles a resource can play within a set of linked

         resources."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/linkage-type|6.0.0-ballot3"/>       </binding>     </element>     <element id="Linkage.item.resource">      <path value="Linkage.item.resource"/>       <short value="Resource being linked"/>       <definition value="The resource instance being linked as part of the group."/>       <min value="1"/>       <max value="1"/>       <base>         <path value="Linkage.item.resource"/>         <min value="1"/>         <max value="1"/>       </base>       <type>         <code value="Reference"/>         <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/>       </type>       <constraint>         <key value="ele-1"/>         <severity value="error"/>         <human value="All FHIR elements must have a @value or children"/>         <expression value="hasValue() or (children().count() &gt; id.count())"/>         <source value="http://hl7.org/fhir/StructureDefinition/Element"/>       </constraint>       <mustSupport value="false"/>       <isModifier value="false"/>       <isSummary value="true"/>     </element>   </snapshot>   <differential>     <element id="Linkage">      <path value="Linkage"/>       <short value="Links records for 'same' item"/> 
      <definition value="Identifies two or more records (resource instances) that refer to the same real-world
       &quot;occurrence&quot;.
      
      
      
        
        
        
        
        
      
      
        
        
      
    
    
      
      
      
      
      
      
      
      
        
      
      This resource is generally assumed to be active if no value is provided for the active
       element
      
      
        
        
      
    
    
      
      
      Identifies the user or organization responsible for asserting the linkages as well as
       the user or organization who establishes the context in which the nature of each linkage
       is evaluated.
      &quot;Primary&quot; for the same set of linked resources may be different from different
       user's/organization's perspectives.
      
      
      
        
        
        
        
      
      
      
        
        
      
    
    
      
      
      Identifies which record considered as the reference to the same real-world occurrence
       as well as how the items should be evaluated within the collection of linked items.
      
      
      
        
      
      
      
    
    
      
      
      Distinguishes which item is &quot;source of truth&quot; (if any) and which items are no
       longer considered to be current representations.
      
      
      
        
      
      
      
        
          
        
        
        
        
      
    
    
      
      
      
      
      
      
        
        
      
      
    
  

       &quot;occurrence&quot;."/> 
      <min value="0"/>       <max value="*"/>       <constraint>         <key value="lnk-1"/>         <severity value="error"/>         <human value="Must have at least two items"/>         <expression value="item.count()&gt;1"/>         <source value="http://hl7.org/fhir/StructureDefinition/Linkage"/>       </constraint>       <mustSupport value="false"/>       <isModifier value="false"/>       <mapping>         <identity value="w5"/>         <map value="infrastructure.structure"/>       </mapping>       <mapping>         <identity value="rim"/>         <map value="N/A - RIM doesn't know how to do this"/>       </mapping>     </element>     <element id="Linkage.active">      <path value="Linkage.active"/>       <short value="Whether this linkage assertion is active or not"/>       <definition value="Indicates whether the asserted set of linkages are considered to be &quot;in effect&quot;."/>       <comment value="If false, any asserted linkages should not be considered current/relevant/applicable."/>       <requirements value="Need to be able to mark a linkage record as not to be used because it was created

       in error."/> 
      <min value="0"/>       <max value="1"/>       <type>         <code value="boolean"/>       </type>       <meaningWhenMissing value="This resource is generally assumed to be active if no value is provided for the

       active element"/> 
      <mustSupport value="false"/>       <isModifier value="false"/>       <isSummary value="true"/>       <mapping>         <identity value="w5"/>         <map value="FiveWs.status"/>       </mapping>     </element>     <element id="Linkage.author">      <path value="Linkage.author"/>       <short value="Who is responsible for linkages"/>       <definition value="Identifies the user or organization responsible for asserting the linkages and

       establishing the context in which the nature of each linkage is evaluated."/> 
      <min value="0"/>       <max value="1"/>       <type>         <code value="Reference"/>         <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>         <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>         <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/>       </type>       <mustSupport value="false"/>       <isModifier value="false"/>       <isSummary value="true"/>       <mapping>         <identity value="w5"/>         <map value="FiveWs.author"/>       </mapping>     </element>     <element id="Linkage.item">      <path value="Linkage.item"/>       <short value="Item to be linked"/>       <definition value="Identifies a member of a set of resource instances considered to refer to the same

       real-world entity and classifies the role of the resource instance in the set."/> 
      <min value="1"/>       <max value="*"/>       <type>         <code value="BackboneElement"/>       </type>       <condition value="lnk-1"/>       <mustSupport value="false"/>       <isModifier value="false"/>       <isSummary value="true"/>     </element>     <element id="Linkage.item.type">      <path value="Linkage.item.type"/>       <short value="source | alternate | historical"/>       <definition value="Distinguishes which item is &quot;source of truth&quot; (if any) and which items

       are no longer considered to be current representations."/> 
      <min value="1"/>       <max value="1"/>       <type>         <code value="code"/>       </type>       <mustSupport value="false"/>       <isModifier value="false"/>       <isSummary value="true"/>       <binding>         <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">          <valueString value="LinkageType"/>         </extension>         <strength value="required"/>         <description value="Used to distinguish different roles a resource can play within a set of linked

         resources."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/linkage-type|6.0.0-ballot3"/>       </binding>     </element>     <element id="Linkage.item.resource">      <path value="Linkage.item.resource"/>       <short value="Resource being linked"/>       <definition value="The resource instance being linked as part of the group."/>       <min value="1"/>       <max value="1"/>       <type>         <code value="Reference"/>         <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/>       </type>       <mustSupport value="false"/>       <isModifier value="false"/>       <isSummary value="true"/>     </element>   </differential> 


</

StructureDefinition

>



Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.