StructureDefinition: Clinical Document - XML

Clinical Document

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

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="clinicaldocument"/> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">to do</div> 
  </text> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="2"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="sd"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use"/> 
  </extension> 
  <url value="http://hl7.org/fhir/StructureDefinition/clinicaldocument"/> 
  

  <identifier> 
    <system value="urn:ietf:rfc:3986"/> 
    <value value="urn:oid:2.16.840.1.113883.4.642.5.1178"/> 
  </identifier> 
  <version value="5.0.0-snapshot3"/> 
  <name value="Clinical Document"/> 
  <title value="Clinical Document"/> 
  <status value="draft"/> 
  <experimental value="false"/> 
  <date value="2015-03-17"/> 
  <publisher value="Health Level Seven, Inc. - Structured Documents WG"/> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://hl7.org/special/committees/structure"/> 
    </telecom> 
  </contact> 
  The Clinical Document profile constrains Composition to specify a clinical document (matching
   CDA). 

  <description value="The Clinical Document profile constrains Composition to specify a clinical document
   (matching CDA). 


The base Composition is a general resource for compositions or documents about any kind
   of subject that might be encountered in healthcare including such things as guidelines,
   medicines, etc. A clinical document is focused on documents related to the provision of
   care process, where the subject is a patient, a group of patients, or a closely related
   concept. A clinical document has additional requirements around confidentiality that do
   not apply in the same way to other kinds of documents.
  

The base Composition is a general resource for compositions or documents about
   any kind of subject that might be encountered in healthcare including such things
   as guidelines, medicines, etc. A clinical document is focused on documents related
   to the provision of care process, where the subject is a patient, a group of patients,
   or a closely related concept. A clinical document has additional requirements around
   confidentiality that do not apply in the same way to other kinds of documents."/> 
  <fhirVersion value="5.0.0"/> 
  <mapping> 
    <identity value="workflow"/> 
    <uri value="http://hl7.org/fhir/workflow"/> 
    <name value="Workflow Pattern"/> 
  </mapping> 
  <mapping> 
    <identity value="rim"/> 
    <uri value="http://hl7.org/v3"/> 
    <name value="RIM Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="cda"/> 
    <uri value="http://hl7.org/v3/cda"/> 
    <name value="CDA (R2)"/> 
  </mapping> 
  <mapping> 
    <identity value="fhirdocumentreference"/> 
    <uri value="http://hl7.org/fhir/documentreference"/> 
    <name value="FHIR DocumentReference"/> 
  </mapping> 
  <mapping> 
    <identity value="w5"/> 
    <uri value="http://hl7.org/fhir/fivews"/> 
    <name value="FiveWs Pattern Mapping"/> 
  </mapping> 
  <kind value="resource"/> 
  <abstract value="false"/> 
  <type value="Composition"/> 
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Composition"/> 
  <derivation value="constraint"/> 
  <snapshot> 
    <element id="Composition">
      <path value="Composition"/> 
      
      A set of healthcare-related information that is assembled together into a single logical
       package that provides a single coherent statement of meaning, establishes its own context
       and that has clinical attestation with regard to who is making the statement. A Composition
       defines the structure and narrative content necessary for a document. However, a Composition
       alone does not constitute a document. Rather, the Composition must be the first entry
       in a Bundle where Bundle.type=document, and any other resources referenced from Composition
       must be included as subsequent entries in the Bundle (for example Patient, Practitioner,
       Encounter, etc.).
      While the focus of this specification is on patient-specific clinical statements, this
       resource can also apply to other healthcare-related statements such as study protocol
       designs, healthcare invoices and other activities that are not necessarily patient-specific
       or clinical.

      <short value="A set of resources composed into a single coherent clinical statement with clinical
       attestation"/> 
      <definition value="A set of healthcare-related information that is assembled together into a single

       logical package that provides a single coherent statement of meaning, establishes
       its own context and that has clinical attestation with regard to who is making
       the statement. A Composition defines the structure and narrative content necessary
       for a document. However, a Composition alone does not constitute a document. Rather,
       the Composition must be the first entry in a Bundle where Bundle.type=document,
       and any other resources referenced from Composition must be included as subsequent
       entries in the Bundle (for example Patient, Practitioner, Encounter, etc.)."/> 
      <comment value="While the focus of this specification is on patient-specific clinical statements,

       this resource can also apply to other healthcare-related statements such as study
       protocol designs, healthcare invoices and other activities that are not necessarily
       patient-specific or clinical."/> 

      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Composition"/> 
        <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"/> 
        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.exists() and ('#'+id in (%resource.descendants().reference | %resource.descenda
        nts().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))))

        <human value="If the resource is contained in another resource, it SHALL be referred to from
         elsewhere in the resource or SHALL refer to the containing resource"/> 
        <expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofTy

        pe(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url)))

         or descendants().where(reference = '#').exists() or descendants().where(as(canonical)
         = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched',
         id).empty()
        not(exists(for $contained in f:contained return $contained[not(exists(parent::*/descendant::f:refere
        nce/@value=concat('#', $contained/*/f:id/@value)) or exists(descendant::f:reference[@value='#']))]))

         = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched
        ', id).empty()"/> 

        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-4"/> 
        <severity value="error"/> 
        If a resource is contained in another resource, it SHALL NOT have a meta.versionId or
         a meta.lastUpdated

        <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">
          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.

          <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> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Entity. Role, or Act"/> 
      </mapping> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Document[classCode=&quot;DOC&quot; and moodCode=&quot;EVN&quot; and isNormalAct()]"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value="ClinicalDocument"/> 
      </mapping> 
      <mapping> 
        <identity value="fhirdocumentreference"/> 
        <map value="when described by DocumentReference"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="infrastructure.documents"/> 
      </mapping> 
    </element> 
    <element id="Composition.id">
      <path value="Composition.id"/> 
      <short value="Logical id of this artifact"/> 
      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.

      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned,
       this value never changes."/> 
      <comment value="Within the context of the FHIR RESTful interactions, the resource has an id except

       for cases like the create and conditional update. Otherwise, the use of the resouce
       id depends on the given use case."/> 

      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="Composition.meta">
      <path value="Composition.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.

       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="Composition.implicitRules">
      <path value="Composition.implicitRules"/> 
      <short value="A set of rules under which this content was created"/> 
      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.

      <definition value="A reference to a set of rules that were followed when the resource was constructed,
       and which must be understood when processing the content. Often, this is a reference
       to an implementation guide that defines the special rules along with other profiles
       etc."/> 
      <comment value="Asserting this rule set restricts the content to be only understood by a limited

       set of trading partners. This inherently limits the usefulness of the data in the
       long term. However, the existing health eco-system is highly fractured, and not
       yet ready to define, collect, and exchange data in a generally computable sense.
       Wherever possible, implementers and/or specification writers should avoid using
       this element. Often, when used, the URL is a reference to an implementation guide
       that defines these special rules as part of it's 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"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="Composition.language">
      <path value="Composition.language"/> 
      <short value="Language of the resource content"/> 
      <definition value="The base language in which the resource is written."/> 
      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).

      <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-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="IETF language tag"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> 
      </binding> 
    </element> 
    <element id="Composition.text">
      <path value="Composition.text"/> 
      <short value="Text summary of the resource, for human interpretation"/> 
      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.

      <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> 
      <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="Composition.contained">
      <path value="Composition.contained"/> 
      <short value="Contained, inline Resources"/> 
      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.

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

       identification is lost, it is extremely difficult (and context dependent) to restore
       it again. Contained resources may have profiles and tags in their meta elements,
       but SHALL NOT have security labels."/> 

      <alias value="inline resources"/> 
      <alias value="anonymous resources"/> 
      <alias value="contained resources"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.contained"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Resource"/> 
      </type> 
      
        
        
        Containing new R4B resources within R4 resources may cause interoperability issues if
         instances are shared with R4 systems
        ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable
         or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this
         is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition
         or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus
         or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence
         or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefi
        nition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition
         or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorizat
        ion or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource
         is SubscriptionTopic)
        not(f:Citation|f:Evidence|f:EvidenceReport|f:EvidenceVariable|f:MedicinalProductDefinition|f:Package
        dProductDefinition|f:AdministrableProductDefinition|f:Ingredient|f:ClinicalUseDefinition|f:RegulatedA
        uthorization|f:SubstanceDefinition|f:SubscriptionStatus|f:SubscriptionTopic) or not(parent::f:Citatio
        n|parent::f:Evidence|parent::f:EvidenceReport|parent::f:EvidenceVariable|parent::f:MedicinalProductDe
        finition|parent::f:PackagedProductDefinition|parent::f:AdministrableProductDefinition|parent::f:Ingre
        dient|parent::f:ClinicalUseDefinition|parent::f:RegulatedAuthorization|parent::f:SubstanceDefinition|
        f:SubscriptionStatus|f:SubscriptionTopic)
        
      

      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Composition.extension">
      <path value="Composition.extension"/> 
      <slicing> 
        <discriminator> 
          <type value="value"/> 
          <path value="url"/> 
        </discriminator> 
        <ordered value="false"/> 
        <rules value="open"/> 
      </slicing> 
      <short value="Extension"/> 
      <definition value="An Extension"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="Composition.extension:versionNumber">
      <path value="Composition.extension"/> 
      <sliceName value="versionNumber"/> 
      <short value="Version-specific identifier for composition"/> 
      

      <definition value="Version specific identifier for the composition, assigned when each version is
       created/updated."/> 

      <comment value="While each resource, including the composition itself, has its own version identifier,
       this is a formal identifier for the logical version of the composition as a whole. It
       would remain constant if the resources were moved to a new server, and all got new individual
       resource versions, for example.

       this is a formal identifier for the logical version of the composition as a whole.
       It would remain constant if the resources were moved to a new server, and all got
       new individual resource versions, for example."/> 

      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber"/> 
      </type> 
      

      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        
        
        

        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
    </element> 
    <element id="Composition.modifierExtension">
      <path value="Composition.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.

       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 SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,

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

       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 

      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      Modifier extensions are expected to modify the meaning or interpretation of the resource
       that contains them
      

      <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="Composition.url">
      <path value="Composition.url"/> 
      <short value="Canonical identifier for this Composition, represented as a URI (globally unique)"/> 
      <definition value="An absolute URI that is used to identify this Composition when it is referenced
       in a specification, model, design or an instance; also called its canonical identifier.
       This SHOULD be globally unique and SHOULD be a literal address at which an authoritative
       instance of this Composition is (or will be) published. This URL can be the target
       of a canonical reference. It SHALL remain the same when the Composition is stored
       on different servers."/> 
      <comment value="Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple

       instances may share the same URL if they have a distinct version."/> 
      <requirements value="Allows the Composition to be referenced by a single globally unique identifier."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.url"/> 
        <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="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
    </element> 
    <element id="Composition.identifier">
      <path value="Composition.identifier"/> 
      <short value="Version-independent identifier for the Composition"/> 
      A version-independent identifier for the Composition. This identifier stays constant as
       the composition is changed over time.
      Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how
       these relate.

      <definition value="A version-independent identifier for the Composition. This identifier stays constant
       as the composition is changed over time."/> 
      <comment value="Similar to ClinicalDocument/setId in CDA. See discussion in resource definition

       for how these relate."/> 

      <min value="0"/> 
      

      <max value="*"/> 
      <base> 
        <path value="Composition.identifier"/> 
        <min value="0"/> 
        

        <max value="*"/> 
      </base> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Document.id / Document.setId"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".setId"/> 
      </mapping> 
      <mapping> 
        <identity value="fhirdocumentreference"/> 
        <map value="DocumentReference.masterIdentifier"/> 
      </mapping> 
    </element> 
    <element id="Composition.version">
      <path value="Composition.version"/> 
      <short value="An explicitly assigned identifer of a variation of the content in the Composition"/> 
      <definition value="An explicitly assigned identifer of a variation of the content in the Composition."/> 
      <comment value="While each resource, including the composition itself, has its own version identifier,
       this is a formal identifier for the logical version of the Composition as a whole.
       It would remain constant if the resources were moved to a new server, and all got
       new individual resource versions, for example."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.version"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.version"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".versionNumber"/> 
      </mapping> 
    </element> 
    <element id="Composition.status">
      <path value="Composition.status"/> 
      
      The workflow/clinical status of this composition. The status is a marker for the clinical
       standing of the document.
      If a composition is marked as withdrawn, the compositions/documents in the series, or
       data from the composition or document series, should never be displayed to a user without
       being clearly marked as untrustworthy. The flag &quot;entered-in-error&quot; is why this
       element is labeled as a modifier of other elements.   

      <short value="registered | partial | preliminary | final | amended | corrected | appended | cancelled
       | entered-in-error | deprecated | unknown"/> 
      <definition value="The workflow/clinical status of this composition. The status is a marker for the

       clinical standing of the document."/> 
      <comment value="If a composition is marked as withdrawn, the compositions/documents in the series,

       or data from the composition or document series, should never be displayed to a
       user without being clearly marked as untrustworthy. The flag &quot;entered-in-error&quot;
       is why this element is labeled as a modifier of other elements.   


Some reporting work flows require that the original narrative of a final document never
       be altered; instead, only new narrative can be added. The composition resource has no
       explicit status for explicitly noting whether this business rule is in effect. This would
       be handled by an extension if required.

Some reporting work flows require that the original narrative of a final document
       never be altered; instead, only new narrative can be added. The composition resource
       has no explicit status for explicitly noting whether this business rule is in effect.
       This would be handled by an extension if required."/> 

      <requirements value="Need to be able to mark interim, amended, or withdrawn compositions or documents."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.status"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      This element is labelled as a modifier because it is a status element that contains status
       entered-in-error which means that the resource should not be treated as valid

      <isModifierReason value="This element is labelled as a modifier because it is a status element that contains
       status entered-in-error which means that the resource should not be treated as
       valid"/> 

      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="CompositionStatus"/> 
        </extension> 
        <strength value="required"/> 
        <description value="The workflow/clinical status of the composition."/> 
        

        <valueSet value="http://hl7.org/fhir/ValueSet/composition-status|5.0.0-snapshot3"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.status"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.status"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        interim: .completionCode=&quot;IN&quot; &amp; ./statusCode[isNormalDatatype()]=&quot;active&quot;;
          final: .completionCode=&quot;AU&quot; &amp;&amp;  ./statusCode[isNormalDatatype()]=&quot;complete&q
        uot; and not(./inboundRelationship[typeCode=&quot;SUBJ&quot; and isNormalActRelationship()]/source[su
        bsumesCode(&quot;ActClass#CACT&quot;) and moodCode=&quot;EVN&quot; and domainMember(&quot;ReviseCompo
        sition&quot;, code) and isNormalAct()]);  amended: .completionCode=&quot;AU&quot; &amp;&amp;
          ./statusCode[isNormalDatatype()]=&quot;complete&quot; and ./inboundRelationship[typeCode=&quot;SUBJ
        &quot; and isNormalActRelationship()]/source[subsumesCode(&quot;ActClass#CACT&quot;) and
         moodCode=&quot;EVN&quot; and domainMember(&quot;ReviseComposition&quot;, code) and isNormalAct()
         and statusCode=&quot;completed&quot;];  withdrawn : .completionCode=NI &amp;&amp;  ./statusCode[isNo
        rmalDatatype()]=&quot;obsolete&quot;

        <map value="interim: .completionCode=&quot;IN&quot; &amp; ./statusCode[isNormalDatatype()]=&quot;active&q
        uot;;  final: .completionCode=&quot;AU&quot; &amp;&amp;  ./statusCode[isNormalDatatype()]=&quo
        t;complete&quot; and not(./inboundRelationship[typeCode=&quot;SUBJ&quot; and isNormalActRelati
        onship()]/source[subsumesCode(&quot;ActClass#CACT&quot;) and moodCode=&quot;EVN&quot;
         and domainMember(&quot;ReviseComposition&quot;, code) and isNormalAct()]);  amended:
         .completionCode=&quot;AU&quot; &amp;&amp;  ./statusCode[isNormalDatatype()]=&quot;complete&qu
        ot; and ./inboundRelationship[typeCode=&quot;SUBJ&quot; and isNormalActRelationship()]/source[
        subsumesCode(&quot;ActClass#CACT&quot;) and moodCode=&quot;EVN&quot; and domainMember(&quot;Re
        viseComposition&quot;, code) and isNormalAct() and statusCode=&quot;completed&quot;];
          withdrawn : .completionCode=NI &amp;&amp;  ./statusCode[isNormalDatatype()]=&quot;obsolete&q
        uot;"/> 

      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value="n/a"/> 
      </mapping> 
      <mapping> 
        <identity value="fhirdocumentreference"/> 
        <map value="DocumentReference.status"/> 
      </mapping> 
    </element> 
    <element id="Composition.type">
      <path value="Composition.type"/> 
      <short value="Kind of composition (LOINC if possible)"/> 
      Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary,
       Progress Note). This usually equates to the purpose of making the composition.

      <definition value="Specifies the particular kind of composition (e.g. History and Physical, Discharge
       Summary, Progress Note). This usually equates to the purpose of making the composition."/> 

      <comment value="For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation
       guides will require a specific LOINC code, or use LOINC as an extensible binding."/> 
      <requirements value="Key metadata element describing the composition, used in searching/filtering."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.type"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DocumentType"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Type of a composition."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/doc-typecodes"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.code"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.class"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="./code"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".code"/> 
      </mapping> 
      <mapping> 
        <identity value="fhirdocumentreference"/> 
        <map value="DocumentReference.type"/> 
      </mapping> 
    </element> 
    <element id="Composition.category">
      <path value="Composition.category"/> 
      <short value="Categorization of Composition"/> 
      A categorization for the type of the composition - helps for indexing and searching. This
       may be implied by or derived from the code specified in the Composition Type.
      This is a metadata field from [XDS/MHD](http://wiki.ihe.net/index.php?title=Mobile_access_to_Health_
      Documents_(MHD)).
      Helps humans to assess whether the composition is of interest when viewing an index of
       compositions or documents.

      <definition value="A categorization for the type of the composition - helps for indexing and searching.
       This may be implied by or derived from the code specified in the Composition Type."/> 
      <requirements value="Helps humans to assess whether the composition is of interest when viewing an index

       of compositions or documents."/> 

      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Composition.category"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DocumentCategory"/> 
        </extension> 
        <strength value="example"/> 
        <description value="High-level kind of a clinical document at a macro level."/> 
        

        <valueSet value="http://hl7.org/fhir/ValueSet/referenced-item-category"/> 
      </binding> 
      <mapping> 
        
        
      
      

        <identity value="w5"/> 
        <map value="FiveWs.class"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        .outboundRelationship[typeCode=&quot;COMP].target[classCode=&quot;LIST&quot;, moodCode=&quot;EVN&quo
        t;].code

        <map value=".outboundRelationship[typeCode=&quot;COMP].target[classCode=&quot;LIST&quot;, moodCode=&quot;
        EVN&quot;].code"/> 

      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value="n/a"/> 
      </mapping> 
      <mapping> 
        <identity value="fhirdocumentreference"/> 
        <map value="DocumenttReference.category"/> 
      </mapping> 
    </element> 
    <element id="Composition.subject">
      <path value="Composition.subject"/> 
      <short value="Who and/or what the composition is about"/> 
      <definition value="Who or what the composition is about. The composition can be about a person, (patient
       or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such
       as a document about a herd of livestock, or a set of patients that share a common exposure).

       or healthcare practitioner), a device (e.g. a machine) or even a group of subjects
       (such as a document about a herd of livestock, or a set of patients that share
       a common exposure)."/> 

      <comment value="For clinical documents, this is usually the patient."/> 
      Essential metadata for searching for the composition. Identifies who and/or what the composition/doc
      ument is about.

      <requirements value="Essential metadata for searching for the composition. Identifies who and/or what
       the composition/document is about."/> 

      <min value="0"/> 
      

      <max value="*"/> 
      <base> 
        <path value="Composition.subject"/> 
        <min value="0"/> 
        

        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/> 
      </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="workflow"/> 
        <map value="Event.subject"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=&quot;SBJ&quot;].role[typeCode=&quot;PAT&quot;]"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".recordTarget"/> 
      </mapping> 
      <mapping> 
        <identity value="fhirdocumentreference"/> 
        <map value="DocumentReference.subject"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject"/> 
      </mapping> 
    </element> 
    <element id="Composition.encounter">
      <path value="Composition.encounter"/> 
      <short value="Context of the Composition"/> 
      

      <definition value="Describes the clinical encounter or type of care this documentation is associated
       with."/> 

      <requirements value="Provides context for the composition and supports searching."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.encounter"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> 
      </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="workflow"/> 
        

        <map value="Event.encounter"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.context"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        unique(highest(./outboundRelationship[typeCode=&quot;SUBJ&quot; and isNormalActRelationship()],
         priorityNumber)/target[moodCode=&quot;EVN&quot; and classCode=(&quot;ENC&quot;, &quot;PCPR&quot;)
         and isNormalAct])

        <map value="unique(highest(./outboundRelationship[typeCode=&quot;SUBJ&quot; and isNormalActRelationship()
        ], priorityNumber)/target[moodCode=&quot;EVN&quot; and classCode=(&quot;ENC&quot;,
         &quot;PCPR&quot;) and isNormalAct])"/> 

      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".componentOf.encompassingEncounter"/> 
      </mapping> 
      <mapping> 
        <identity value="fhirdocumentreference"/> 
        <map value="DocumentReference.context.encounter"/> 
      </mapping> 
    </element> 
    <element id="Composition.date">
      <path value="Composition.date"/> 
      <short value="Composition editing time"/> 
      
      The Last Modified Date on the composition may be after the date of the document was attested
       without being changed.
      dateTime is used for tracking, organizing versions and searching. Note that this is the
       time of *authoring*. When packaged in a document, [Bundle.timestamp](bundle-definitions.html#Bundle.
      timestamp) is the date of packaging.

      <definition value="The composition editing time, when the composition was last logically changed by
       the author."/> 
      <comment value="The Last Modified Date on the composition may be after the date of the document

       was attested without being changed. This means that the date on an amended document
       is the date of the amendment, not the date of original authorship."/> 
      <requirements value="dateTime is used for tracking, organizing versions and searching. Note that this

       is the time of authoring this version of the Composition. When packaged in a document,
       [Bundle.timestamp](bundle-definitions.html#Bundle.timestamp) is the date of packaging."/> 

      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.date"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.occurrence[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.done[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime[type=&quot;TS&quot;]"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".effectiveTime"/> 
      </mapping> 
      <mapping> 
        <identity value="fhirdocumentreference"/> 
        <map value="DocumentReference.content.attachment.date, DocumentReference.created"/> 
      </mapping> 
    </element> 
    <element id="Composition.useContext">
      <path value="Composition.useContext"/> 
      <short value="The context that the content is intended to support"/> 
      <definition value="The content was developed with a focus and intent of supporting the contexts that
       are listed. These contexts may be general categories (gender, age, ...) or may
       be references to specific programs (insurance plans, studies, ...) and may be used
       to assist with indexing and searching for appropriate Composition instances."/> 
      <comment value="When multiple useContexts are specified, there is no expectation that all or any

       of the contexts apply."/> 
      <requirements value="Assist in searching for appropriate content."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Composition.useContext"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="UsageContext"/> 
      </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="Composition.author">
      <path value="Composition.author"/> 
      <short value="Who and/or what authored the composition"/> 
      <definition value="Identifies who is responsible for the information in the composition, not necessarily
       who typed it in."/> 
      <requirements value="Identifies who is responsible for the content."/> 
      <min value="1"/> 
      <max value="*"/> 
      <base> 
        <path value="Composition.author"/> 
        <min value="1"/> 
        <max value="*"/> 
      </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/Device"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> 
        <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="workflow"/> 
        <map value="Event.performer"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.author"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=&quot;AUT&quot;].role[classCode=&quot;ASSIGNED&quot;]"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".author.assignedAuthor"/> 
      </mapping> 
      <mapping> 
        <identity value="fhirdocumentreference"/> 
        <map value="DocumentReference.agent"/> 
      </mapping> 
    </element> 
    <element id="Composition.name">
      <path value="Composition.name"/> 
      <short value="Name for this Composition (computer friendly)"/> 
      <definition value="A natural language name identifying the {{title}}. This name should be usable as
       an identifier for the module by machine processing applications such as code generation."/> 
      <comment value="The name is not expected to be globally unique. The name should be a simple alphanumeric

       type name to ensure that it is machine-processing friendly."/> 
      <requirements value="Support human navigation and code generation."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.name"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="Composition.title">
      <path value="Composition.title"/> 
      <short value="Human Readable name/title"/> 
      <definition value="Official human-readable label for the composition."/> 
      For many compositions, the title is the same as the text or a display name of Composition.type
       (e.g. a &quot;consultation&quot; or &quot;progress note&quot;). Note that CDA does not
       make title mandatory, but there are no known cases where it is useful for title to be
       omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial
       use period.

      <comment value="For many compositions, the title is the same as the text or a display name of Composition.typ
      e (e.g. a &quot;consultation&quot; or &quot;progress note&quot;). Note that CDA
       does not make title mandatory, but there are no known cases where it is useful
       for title to be omitted, so it is mandatory here. Feedback on this requirement
       is welcome during the trial use period."/> 

      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.title"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="./title"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".title"/> 
      </mapping> 
      <mapping> 
        <identity value="fhirdocumentreference"/> 
        <map value="DocumentReference.description, DocumentReference.content.attachment.title"/> 
      </mapping> 
    </element> 
    
      
      
      
      The exact use of this element, and enforcement and issues related to highly sensitive
       documents are out of scope for the base specification, and delegated to implementation
       profiles (see security section).  This element is labeled as a modifier because highly
       confidential documents must not be treated as if they are not.

    <element id="Composition.note">
      <path value="Composition.note"/> 
      <short value="For any additional notes"/> 
      <definition value="For any additional notes."/> 
      <comment value="A comment, general note or annotation not coded elsewhere."/> 
      <min value="0"/> 
      

      <max value="*"/> 
      <base> 
        

        <path value="Composition.note"/> 
        <min value="0"/> 
        

        <max value="*"/> 
      </base> 
      <type> 
        

        <code value="Annotation"/> 
      </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"/> 
    </element> 
    <element id="Composition.attester">
      <path value="Composition.attester"/> 
      <short value="Attests to accuracy of composition"/> 
      <definition value="A participant who has attested to the accuracy of the composition/document."/> 
      <comment value="Only list each attester once."/> 
      <requirements value="Identifies responsibility for the accuracy of the composition content."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Composition.attester"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        
        
        

        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=&quot;AUTHEN&quot;].role[classCode=&quot;ASSIGNED&quot;]"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".authenticator/.legalAuthenticator"/> 
      </mapping> 
      <mapping> 
        <identity value="fhirdocumentreference"/> 
        <map value="DocumentReference.authenticator"/> 
      </mapping> 
    </element> 
    <element id="Composition.attester.id">
      <path value="Composition.attester.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces.

      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 

      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Composition.attester.extension">
      <path value="Composition.attester.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 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."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,

       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 

      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Composition.attester.modifierExtension">
      <path value="Composition.attester.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is contained
       and/or the understanding of the containing element's descendants. Usually modifier elements
       provide negation or qualification. To make the use of extensions safe and 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.

       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 SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,

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

       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 

      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them

      <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="Composition.attester.mode">
      <path value="Composition.attester.mode"/> 
      <short value="personal | professional | legal | official"/> 
      <definition value="The type of attestation the authenticator offers."/> 
      <requirements value="Indicates the level of authority of the attestation."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.attester.mode"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        

        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="CompositionAttestationMode"/> 
        </extension> 
        

        <strength value="preferred"/> 
        <description value="The way in which a person authenticated a composition."/> 
        

        <valueSet value="http://hl7.org/fhir/ValueSet/composition-attestation-mode"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="unique(./modeCode)"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value="implied by .authenticator/.legalAuthenticator"/> 
      </mapping> 
    </element> 
    <element id="Composition.attester.time">
      <path value="Composition.attester.time"/> 
      <short value="When the composition was attested"/> 
      <definition value="When the composition was attested by the party."/> 
      Identifies when the information in the composition was deemed accurate.  (Things may have
       changed since then.).

      <requirements value="Identifies when the information in the composition was deemed accurate.  (Things
       may have changed since then.)."/> 

      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.attester.time"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="./time[type=&quot;TS&quot; and isNormalDatatype()]"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".authenticator.time"/> 
      </mapping> 
    </element> 
    <element id="Composition.attester.party">
      <path value="Composition.attester.party"/> 
      <short value="Who attested the composition"/> 
      <definition value="Who attested the composition in the specified way."/> 
      

      <requirements value="Identifies who has taken on the responsibility for accuracy of the composition
       content."/> 

      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.attester.party"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.witness"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        ./role[classCode=&quot;ASSIGNED&quot; and isNormalRole]/player[determinerCode=&quot;INST&quot;
         and classCode=(&quot;DEV&quot;, &quot;PSN&quot;) and isNormalEntity()] or ./role[classCode=&quot;ASS
        IGNED&quot; and isNormalRole and not(player)]/scoper[determinerCode=&quot;INST&quot; and
         classCode=&quot;ORG&quot; and isNormalEntity()]

        <map value="./role[classCode=&quot;ASSIGNED&quot; and isNormalRole]/player[determinerCode=&quot;INST&quot
        ; and classCode=(&quot;DEV&quot;, &quot;PSN&quot;) and isNormalEntity()] or ./role[classCode=&
        quot;ASSIGNED&quot; and isNormalRole and not(player)]/scoper[determinerCode=&quot;INST&quot;
         and classCode=&quot;ORG&quot; and isNormalEntity()]"/> 

      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".authenticator.assignedEnttty"/> 
      </mapping> 
    </element> 
    <element id="Composition.custodian">
      <path value="Composition.custodian"/> 
      <short value="Organization which maintains the composition"/> 
      Identifies the organization or group who is responsible for ongoing maintenance of and
       access to the composition/document information.
      This is useful when documents are derived from a composition - provides guidance for how
       to get the latest version of the document. This is optional because this is sometimes
       not known by the authoring system, and can be inferred by context. However, it is important
       that this information be known when working with a derived document, so providing a custodian
       is encouraged.

      <definition value="Identifies the organization or group who is responsible for ongoing maintenance
       of and access to the composition/document information."/> 
      <comment value="This is useful when documents are derived from a composition - provides guidance

       for how to get the latest version of the document. This is optional because this
       is sometimes not known by the authoring system, and can be inferred by context.
       However, it is important that this information be known when working with a derived
       document, so providing a custodian is encouraged."/> 

      <requirements value="Identifies where to go to find the current version, where to report issues, etc."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.custodian"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        .participation[typeCode=&quot;RCV&quot;].role[classCode=&quot;CUST&quot;].scoper[classCode=&quot;ORG
        &quot; and determinerCode=&quot;INST&quot;]

        <map value=".participation[typeCode=&quot;RCV&quot;].role[classCode=&quot;CUST&quot;].scoper[classCode=&q
        uot;ORG&quot; and determinerCode=&quot;INST&quot;]"/> 

      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".custodian.assignedCustodian"/> 
      </mapping> 
      <mapping> 
        <identity value="fhirdocumentreference"/> 
        <map value="DocumentReference.custodian"/> 
      </mapping> 
    </element> 
    <element id="Composition.relatesTo">
      <path value="Composition.relatesTo"/> 
      <short value="Relationships to other compositions/documents"/> 
      Relationships that this composition has with other compositions or documents that already
       exist.
      

      <definition value="Relationships that this composition has with other compositions or documents that
       already exist."/> 
      <comment value="To reference (using relatesTo) a Bundle of type &quot;document&quot; or another

       Composition where you only have the identifier, use a resourceReference with an
       identifier.
Here is an example of using relatesTo to reference another Bundle of type &quot;document&quot
      ; or Composition where you only have the identifier:
```
&lt;relatesTo  &gt;
    &lt;type value=&quot;replaces&quot; /&gt;
&lt;resourceReference&gt;
&lt;identifier&gt;
&lt;system value=&quot;...&quot; /&gt;
&lt;value value=&quot;...&quot; /&gt;
&lt;/identifier&gt;
&lt;/resourceReference&gt;
&lt;/relatesTo&gt;
```"/> 

      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Composition.relatesTo"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        

        <code value="RelatedArtifact"/> 
      </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=".outboundRelationship"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".relatedDocument"/> 
      </mapping> 
      <mapping> 
        <identity value="fhirdocumentreference"/> 
        <map value="DocumentReference.relatesTo"/> 
      </mapping> 
    </element> 
    
      
      
      
      Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces.
      
      
      
        
        
        
      
      
        
          
        
        
      
      
      
      
        
        
      
    
    
      
      
      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.
      
      
      
      
      
        
        
        
      
      
        
      
      
        
        
        
        
        
        
      
      
        
        
        
        
        
        
      
      
      
      
        
        
      
    
    
      
      
      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
      
      
        
        
      
    
    
      
      
      
      If this document appends another document, then the document cannot be fully understood
       without also accessing the referenced document.
      
      
      
        
        
        
      
      
        
      
      
        
        
        
        
        
        
      
      
      
      
      
        
          
        
        
        
        
      
      
        
        
      
      
        
        
      
      
        
        
      
    
    
      
      
      
      
      
      
        
        
        
      
      
        
      
      
        
        
      
      
        
        
        
        
        
        
      
      
      
      
      
        
        
      
      
        
        
      
      
        
        
      
    

    <element id="Composition.event">
      <path value="Composition.event"/> 
      <short value="The clinical service(s) being documented"/> 
      <definition value="The clinical service, such as a colonoscopy or an appendectomy, being documented."/> 
      The event needs to be consistent with the type element, though can provide further information
       if desired.

      <comment value="The event needs to be consistent with the type element, though can provide further
       information if desired."/> 

      <requirements value="Provides context for the composition and creates a linkage between a resource describing
       an event and the composition created describing the event."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Composition.event"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        
        
        

        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="outboundRelationship[typeCode=&quot;SUBJ&quot;].target[classCode&lt;'ACT']"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".documentationOf.serviceEvent"/> 
      </mapping> 
      <mapping> 
        <identity value="fhirdocumentreference"/> 
        <map value="DocumentReference.event"/> 
      </mapping> 
    </element> 
    <element id="Composition.event.id">
      <path value="Composition.event.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces.

      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 

      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Composition.event.extension">
      <path value="Composition.event.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 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."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,

       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 

      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Composition.event.modifierExtension">
      <path value="Composition.event.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.

       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 SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,

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

       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 

      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them

      <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="Composition.event.code">
      <path value="Composition.event.code"/> 
      <short value="Code(s) that apply to the event being documented"/> 
      This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy,
       being documented. In some cases, the event is inherent in the typeCode, such as a &quot;History
       and Physical Report&quot; in which the procedure being documented is necessarily a &quot;History
       and Physical&quot; act.
      An event can further specialize the act inherent in the typeCode, such as where it is
       simply &quot;Procedure Report&quot; and the procedure was a &quot;colonoscopy&quot;. If
       one or more eventCodes are included, they SHALL NOT conflict with the values inherent
       in the classCode, practiceSettingCode or typeCode, as such a conflict would create an
       ambiguous situation. This short list of codes is provided to be used as key words for
       certain types of queries.

      <definition value="This list of codes represents the main clinical acts, such as a colonoscopy or
       an appendectomy, being documented. In some cases, the event is inherent in the
       typeCode, such as a &quot;History and Physical Report&quot; in which the procedure
       being documented is necessarily a &quot;History and Physical&quot; act."/> 
      <comment value="An event can further specialize the act inherent in the typeCode, such as where

       it is simply &quot;Procedure Report&quot; and the procedure was a &quot;colonoscopy&quot;.
       If one or more eventCodes are included, they SHALL NOT conflict with the values
       inherent in the classCode, practiceSettingCode or typeCode, as such a conflict
       would create an ambiguous situation. This short list of codes is provided to be
       used as key words for certain types of queries."/> 

      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Composition.event.code"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DocumentEventType"/> 
        </extension> 
        <strength value="example"/> 
        <description value="This list of codes represents the main clinical acts being documented."/> 
        <valueSet value="http://terminology.hl7.org/ValueSet/v3-ActCode"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".code"/> 
      </mapping> 
      <mapping> 
        <identity value="fhirdocumentreference"/> 
        <map value="DocumentReference.event.code"/> 
      </mapping> 
    </element> 
    <element id="Composition.event.period">
      <path value="Composition.event.period"/> 
      <short value="The period covered by the documentation"/> 
      The period of time covered by the documentation. There is no assertion that the documentation
       is a complete representation for this period, only that it documents events during this
       time.

      <definition value="The period of time covered by the documentation. There is no assertion that the
       documentation is a complete representation for this period, only that it documents
       events during this time."/> 

      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.event.period"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Period"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".effectiveTime"/> 
      </mapping> 
      <mapping> 
        <identity value="fhirdocumentreference"/> 
        <map value="DocumentReference.event.period"/> 
      </mapping> 
    </element> 
    <element id="Composition.event.detail">
      <path value="Composition.event.detail"/> 
      <short value="The event(s) being documented"/> 
      The description and/or reference of the event(s) being documented. For example, this could
       be used to document such a colonoscopy or an appendectomy.

      <definition value="The description and/or reference of the event(s) being documented. For example,
       this could be used to document such a colonoscopy or an appendectomy."/> 

      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Composition.event.detail"/> 
        <min value="0"/> 
        <max value="*"/> 
      </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"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=&quot;SUBJ&quot;].target"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Composition.section">
      

      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="Section"/> 
      

      </extension> 
      <path value="Composition.section"/> 
      <short value="Composition is broken into sections"/> 
      <definition value="The root of the sections that make up the composition."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Composition.section"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="cmp-1"/> 
        <severity value="error"/> 
        <human value="A section must contain at least one of text, entries, or sub-sections"/> 
        <expression value="text.exists() or entry.exists() or section.exists()"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Composition"/> 
      </constraint> 
      <constraint> 
        <key value="cmp-2"/> 
        <severity value="error"/> 
        <human value="A section can only have an emptyReason if it is empty"/> 
        <expression value="emptyReason.empty() or entry.empty()"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Composition"/> 
      </constraint> 
      <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"/> 
        ./outboundRelationship[typeCode=&quot;COMP&quot; and isNormalActRelationship()]/target[moodCode=&quo
        t;EVN&quot; and classCode=&quot;DOCSECT&quot; and isNormalAct]

        <map value="./outboundRelationship[typeCode=&quot;COMP&quot; and isNormalActRelationship()]/target[moodCo
        de=&quot;EVN&quot; and classCode=&quot;DOCSECT&quot; and isNormalAct]"/> 

      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".component.structuredBody.component.section"/> 
      </mapping> 
    </element> 
    <element id="Composition.section.id">
      <path value="Composition.section.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces.

      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 

      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Composition.section.extension">
      <path value="Composition.section.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 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."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,

       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 

      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Composition.section.modifierExtension">
      <path value="Composition.section.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.

       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 SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,

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

       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 

      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them

      <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="Composition.section.title">
      <path value="Composition.section.title"/> 
      <short value="Label for section (e.g. for ToC)"/> 
      The label for this particular section.  This will be part of the rendered content for
       the document, and is often used to build a table of contents.
      The title identifies the section for a human reader. The title must be consistent with
       the narrative of the resource that is the target of the section.content reference. Generally,
       sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate.
       Typically, this is where a section has subsections that have their own adequately distinguishing
       title,  or documents that only have a single section. Most Implementation Guides will
       make section title to be a required element.
      Section headings are often standardized for different types of documents.  They give guidance
       to humans on how the document is organized.

      <definition value="The label for this particular section.  This will be part of the rendered content
       for the document, and is often used to build a table of contents."/> 
      <comment value="The title identifies the section for a human reader. The title must be consistent

       with the narrative of the resource that is the target of the section.content reference.
       Generally, sections SHOULD have titles, but in some documents, it is unnecessary
       or inappropriate. Typically, this is where a section has subsections that have
       their own adequately distinguishing title,  or documents that only have a single
       section. Most Implementation Guides will make section title to be a required element."/> 
      <requirements value="Section headings are often standardized for different types of documents.  They

       give guidance to humans on how the document is organized."/> 

      <alias value="header"/> 
      <alias value="label"/> 
      <alias value="caption"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.section.title"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="./title"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".title"/> 
      </mapping> 
    </element> 
    <element id="Composition.section.code">
      <path value="Composition.section.code"/> 
      <short value="Classification of section (recommended)"/> 
      A code identifying the kind of content contained within the section. This must be consistent
       with the section title.
      The code identifies the section for an automated processor of the document. This is particularly
       relevant when using profiles to control the structure of the document.   

      <definition value="A code identifying the kind of content contained within the section. This must
       be consistent with the section title."/> 
      <comment value="The code identifies the section for an automated processor of the document. This

       is particularly relevant when using profiles to control the structure of the document.
         


If the section has content (instead of sub-sections), the section.code does not change
       the meaning or interpretation of the resource that is the content of the section in the
       comments for the section.code.

If the section has content (instead of sub-sections), the section.code does not
       change the meaning or interpretation of the resource that is the content of the
       section in the comments for the section.code."/> 

      <requirements value="Provides computable standardized labels to topics within the document."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.section.code"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="CompositionSectionType"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Classification of a section of a composition/document."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/doc-section-codes"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="./code"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="Composition.section.author">
      <path value="Composition.section.author"/> 
      <short value="Who and/or what authored the section"/> 
      Identifies who is responsible for the information in this section, not necessarily who
       typed it in.

      <definition value="Identifies who is responsible for the information in this section, not necessarily
       who typed it in."/> 

      <requirements value="Identifies who is responsible for the content."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Composition.section.author"/> 
        <min value="0"/> 
        <max value="*"/> 
      </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/Device"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> 
        <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="false"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.author"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=&quot;AUT&quot;].role[classCode=&quot;ASSIGNED&quot;]"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".author.assignedAuthor"/> 
      </mapping> 
    </element> 
    <element id="Composition.section.focus">
      <path value="Composition.section.focus"/> 
      <short value="Who/what the section is about, when it is not about the subject of composition"/> 
      The actual focus of the section when it is not the subject of the composition, but instead
       represents something or someone associated with the subject such as (for a patient subject)
       a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to
       be focus of the parent section, or, for a section in the Composition itself, the subject
       of the composition. Sections with a focus SHALL only include resources where the logical
       subject (patient, subject, focus, etc.) matches the section focus, or the resources have
       no logical subject (few resources).
      Typically, sections in a doument are about the subject of the document, whether that is
       a  patient, or group of patients, location, or device, or whatever. For some kind of documents,
       some sections actually contain data about related entities. Typical examples are  a section
       in a newborn discharge summary concerning the mother, or family history documents, with
       a section about each family member, though there are many other examples.

      <definition value="The actual focus of the section when it is not the subject of the composition,
       but instead represents something or someone associated with the subject such as
       (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified,
       the focus is assumed to be focus of the parent section, or, for a section in the
       Composition itself, the subject of the composition. Sections with a focus SHALL
       only include resources where the logical subject (patient, subject, focus, etc.)
       matches the section focus, or the resources have no logical subject (few resources)."/> 
      <comment value="Typically, sections in a doument are about the subject of the document, whether

       that is a  patient, or group of patients, location, or device, or whatever. For
       some kind of documents, some sections actually contain data about related entities.
       Typical examples are  a section in a newborn discharge summary concerning the mother,
       or family history documents, with a section about each family member, though there
       are many other examples."/> 

      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.section.focus"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".subject? (CDA did not differentiate between subject and focus)"/> 
      </mapping> 
    </element> 
    <element id="Composition.section.text">
      <path value="Composition.section.text"/> 
      <short value="Text summary of the section, for human interpretation"/> 
      A human-readable narrative that contains the attested content of the section, 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.
      Document profiles may define what content should be represented in the narrative to ensure
       clinical safety.

      <definition value="A human-readable narrative that contains the attested content of the section, 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."/> 
      <comment value="Document profiles may define what content should be represented in the narrative

       to ensure clinical safety."/> 

      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.section.text"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Narrative"/> 
      </type> 
      <condition value="cmp-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="Composition.section.mode">
      <path value="Composition.section.mode"/> 
      <short value="working | snapshot | changes"/> 
      How the entry list was prepared - whether it is a working list that is suitable for being
       maintained on an ongoing basis, or if it represents a snapshot of a list of items from
       another source, or whether it is a prepared list where items may be marked as added, modified
       or deleted.

      <definition value="How the entry list was prepared - whether it is a working list that is suitable
       for being maintained on an ongoing basis, or if it represents a snapshot of a list
       of items from another source, or whether it is a prepared list where items may
       be marked as added, modified or deleted."/> 

      <comment value="This element is labeled as a modifier because a change list must not be misunderstood
       as a complete list."/> 
      Sections are used in various ways, and it must be known in what way it is safe to use
       the entries in them.

      <requirements value="Sections are used in various ways, and it must be known in what way it is safe
       to use the entries in them."/> 

      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.section.mode"/> 
        <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="SectionMode"/> 
        </extension> 
        <strength value="required"/> 
        <description value="The processing mode that applies to this section."/> 
        

        <valueSet value="http://hl7.org/fhir/ValueSet/list-mode|5.0.0-snapshot3"/> 
      </binding> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.class"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS&quot;].value"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Composition.section.orderedBy">
      <path value="Composition.section.orderedBy"/> 
      <short value="Order of section entries"/> 
      <definition value="Specifies the order applied to the items in the section entries."/> 
      Applications SHOULD render ordered lists in the order provided, but MAY allow users to
       re-order based on their own preferences as well. If there is no order specified, the order
       is unknown, though there may still be some order.

      <comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users
       to re-order based on their own preferences as well. If there is no order specified,
       the order is unknown, though there may still be some order."/> 

      <requirements value="Important for presentation and rendering.  Lists may be sorted to place more important
       information first or to group related entries."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.section.orderedBy"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="SectionEntryOrder"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="What order applies to the items in the entry."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/list-order"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP].sequenceNumber &gt; 1"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Composition.section.entry">
      <path value="Composition.section.entry"/> 
      <short value="A reference to data that supports this section"/> 
      <definition value="A reference to the actual resource from which the narrative in the section is derived."/> 
      <comment value="If there are no entries in the list, an emptyReason SHOULD be provided."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Composition.section.entry"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <condition value="cmp-2"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP] or  .participation[typeCode=SBJ]"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".entry"/> 
      </mapping> 
    </element> 
    <element id="Composition.section.emptyReason">
      <path value="Composition.section.emptyReason"/> 
      <short value="Why the section is empty"/> 
      If the section is empty, why the list is empty. An empty section typically has some text
       explaining the empty reason.
      The various reasons for an empty section make a significant interpretation to its interpretation.
       Note that this code is for use when the entire section content has been suppressed, and
       not for when individual items are omitted - implementers may consider using a text note
       or a flag on an entry in these cases.
      Allows capturing things like &quot;none exist&quot; or &quot;not asked&quot; which can
       be important for most lists.

      <definition value="If the section is empty, why the list is empty. An empty section typically has
       some text explaining the empty reason."/> 
      <comment value="The various reasons for an empty section make a significant interpretation to its

       interpretation. Note that this code is for use when the entire section content
       has been suppressed, and not for when individual items are omitted - implementers
       may consider using a text note or a flag on an entry in these cases."/> 
      <requirements value="Allows capturing things like &quot;none exist&quot; or &quot;not asked&quot; which

       can be important for most lists."/> 

      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Composition.section.emptyReason"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <condition value="cmp-2"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="SectionEmptyReason"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="If a section is empty, why it is empty."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/list-empty-reason"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ,code&lt;ListEmptyReason].value[type=CD]"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Composition.section.section">
      <path value="Composition.section.section"/> 
      <short value="Nested Section"/> 
      <definition value="A nested sub-section within this section."/> 
      Nested sections are primarily used to help human readers navigate to particular portions
       of the document.

      <comment value="Nested sections are primarily used to help human readers navigate to particular
       portions of the document."/> 

      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Composition.section.section"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <contentReference value="http://hl7.org/fhir/StructureDefinition/Composition#Composition.section"/> 
      <condition value="cmp-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        

        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        ./outboundRelationship[typeCode=&quot;COMP&quot; and isNormalActRelationship()]/target[moodCode=&quo
        t;EVN&quot; and classCode=&quot;DOCSECT&quot; and isNormalAct]

        <map value="./outboundRelationship[typeCode=&quot;COMP&quot; and isNormalActRelationship()]/target[moodCo
        de=&quot;EVN&quot; and classCode=&quot;DOCSECT&quot; and isNormalAct]"/> 

      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".component.section"/> 
      </mapping> 
    </element> 
  </snapshot> 
  <differential> 
    <element id="Composition">
      <path value="Composition"/> 
      <min value="0"/> 
      <max value="*"/> 
    </element> 
    <element id="Composition.extension:versionNumber">
      <path value="Composition.extension"/> 
      <sliceName value="versionNumber"/> 
      <short value="Version-specific identifier for composition"/> 
      

      <definition value="Version specific identifier for the composition, assigned when each version is
       created/updated."/> 

      <comment value="While each resource, including the composition itself, has its own version identifier,
       this is a formal identifier for the logical version of the composition as a whole. It
       would remain constant if the resources were moved to a new server, and all got new individual
       resource versions, for example.

       this is a formal identifier for the logical version of the composition as a whole.
       It would remain constant if the resources were moved to a new server, and all got
       new individual resource versions, for example."/> 

      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber"/> 
      </type> 
    </element> 
    <element id="Composition.subject">
      <path value="Composition.subject"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/> 
      </type> 
    </element> 
  </differential> 


</

StructureDefinition

>