StructureDefinition
for
documentreference
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DocumentReference : A reference to a document of any kind for any purpose. Provides metadata
about the document so that the document can be discovered and managed. The scope of a
document is any seralized object with a mime-type, so includes formal patient centric
documents (CDA), cliical notes, scanned paper, and non-patient specific documents like
policy text.
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padding:0px 4px 0px 4px
padding-left: 3px; padding-right: 3px; border: 1px grey solid; font-weight: bold; color:
black; background-color: #fff5e6
vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
padding:0px 4px 0px 4px
vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
padding:0px 4px 0px 4pxA reference to a document
Elements defined in Ancestors:
The logical id of the resource, as used in the URL for the resource. Once assigned, this
value never changes.,
The metadata about the resource. This is content that is maintained by the infrastructure.
Changes to the content might not always be associated with version changes to the resource.,
A reference to a set of rules that were followed when the resource was constructed, and
which must be understood when processing the content. Often, this is a reference to an
implementation guide that defines the special rules along with other profiles etc.,
,
A human-readable narrative that contains a summary of the resource and can be used to
represent the content of the resource to a human. The narrative need not encode all the
structured data, but is required to contain sufficient detail to make it "clinically
safe" for a human to just read the narrative. Resource definitions may define what
content should be represented in the narrative to ensure clinical safety.,
These resources do not have an independent existence apart from the resource that contains
them - they cannot be identified independently, and nor can they have their own independent
transaction scope.,
May be used to represent additional information that is not part of the basic definition
of the resource. To make the use of extensions safe and manageable, there is a strict
set of governance applied to the definition and use of extensions. Though any implementer
can define an extension, there is a set of requirements that SHALL be met as part of the
definition of the extension.,
May be used to represent additional information that is not part of the basic definition
of the resource and that modifies the understanding of the element that contains it and/or
the understanding of the containing element's descendants. Usually modifier elements provide
negation or qualification. To make the use of extensions safe and manageable, there is
a strict set of governance applied to the definition and use of extensions. Though any
implementer is allowed to define an extension, there is a set of requirements that SHALL
be met as part of the definition of the extension. Applications processing a resource
are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
(including cannot change the meaning of modifierExtension itself).
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DocumentReference.masterIdentifier : Document identifier as assigned by the source of
the document. This identifier is specific to this version of the document. This unique
identifier may be used elsewhere to identify this version of the document.
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DocumentReference.identifier : Other identifiers associated with the document, including
version independent identifiers.
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solid; padding:0px 4px 0px 4pxcurrent | superseded | entered-in-error
(
)
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padding:0px 4px 0px 4pxpreliminary | final | amended | entered-in-error
(
)
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DocumentReference.type : Specifies the particular kind of document referenced (e.g. History
and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of
making the document referenced.
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solid; padding:0px 4px 0px 4px
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solid; padding:0px 4px 0px 4px
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solid; padding:0px 4px 0px 4px
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solid; padding:0px 4px 0px 4pxKind of document (LOINC if possible)
(
Instances are encouraged to draw from the specified codes for interoperability purposes
but are not required to do so to be considered conformant.)
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DocumentReference.category : A categorization for the type of document referenced - helps
for indexing and searching. This may be implied by or derived from the code specified
in the DocumentReference.type.
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padding:0px 4px 0px 4pxCategorization of document
(
Instances are not expected or even encouraged to draw from the specified value set. The
value set merely provides examples of the types of concepts intended to be included.)
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DocumentReference.subject : Who or what the document is about. The document can be about
a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group
of subjects (such as a document about a herd of farm animals, or a set of patients that
share a common exposure).
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DocumentReference.author : Identifies who is responsible for adding the information to
the document.
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(
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vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4pxWho and/or what authored the document
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DocumentReference.authenticator : Which person or organization authenticates that this
document is valid.
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DocumentReference.custodian : Identifies the organization or group who is responsible
for ongoing maintenance of and access to the document.
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DocumentReference.relatesTo : Relationships that this document has with other document
references that already exist.
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DocumentReference.relatesTo.code : The type of relationship that this document has with
anther document.
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solid; padding:0px 4px 0px 4pxreplaces | transforms | signs | appends
(
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(
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DocumentReference.securityLabel : A set of Security-Tag codes specifying the level of
privacy/security of the Document. Note that DocumentReference.meta.security contains the
security labels of the "reference" to the document, while DocumentReference.securityLabel
contains a snapshot of the security labels on the document the reference refers to.
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padding:0px 4px 0px 4pxDocument security-tags
(
To be conformant, the concept in this element SHALL be from the specified value set if
any of the codes within the value set can apply to the concept being communicated. If
the value set does not cover the concept (based on human review), alternate codings (or,
data type allowing, text) may be included instead.)
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DocumentReference.content : The document and format referenced. There may be multiple
content element repetitions, each with a different format.
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DocumentReference.content.attachment : The document or URL of the document along with
critical metadata to prove content has integrity.
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DocumentReference.content.format : An identifier of the document encoding, structure,
and template that the document conforms to beyond the base format indicated in the mimeType.
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solid; padding:0px 4px 0px 4pxFormat/content rules for the document
(
Instances are encouraged to draw from the specified codes for interoperability purposes
but are not required to do so to be considered conformant.)
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DocumentReference.context.encounter : Describes the clinical encounter or type of care
that the document content is associated with.
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(
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DocumentReference.context.event : This list of codes represents the main clinical acts,
such as a colonoscopy or an appendectomy, being documented. In some cases, the event is
inherent in the type Code, such as a "History and Physical Report" in which
the procedure being documented is necessarily a "History and Physical" act.
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(
Instances are not expected or even encouraged to draw from the specified value set. The
value set merely provides examples of the types of concepts intended to be included.)
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DocumentReference.context.period : The time period over which the service that is described
by the document was provided.
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(
Instances are not expected or even encouraged to draw from the specified value set. The
value set merely provides examples of the types of concepts intended to be included.)
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DocumentReference.context.practiceSetting : This property may convey specifics about the
practice setting where the content was created, often reflecting the clinical specialty.
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solid; padding:0px 4px 0px 4pxAdditional details about where the content was created (e.g. clinical specialty)
(
Instances are not expected or even encouraged to draw from the specified value set. The
value set merely provides examples of the types of concepts intended to be included.)
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DocumentReference.context.sourcePatientInfo : The Patient Information as known when the
document was published. May be a reference to a version specific, or contained.
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padding:0px 4px 0px 4px
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padding:0px 4px 0px 4px
(
)
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padding:0px 4px 0px 4px
vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iV
BORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAI0lEQVR42u3QIQEAAAACIL/6/4MvTAQOkLYBAAB4kAAAANwMad9AqkR
jgNAAAAAASUVORK5CYII=)
data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==
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DocumentReference.context.related : Related identifiers or resources associated with the
DocumentReference.
vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px
vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px
vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4px
(
)
vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
solid; padding:0px 4px 0px 4pxRelated identifiers or resources
Documentation for this format
A reference to a document of any kind for any purpose. Provides metadata about the document
so that the document can be discovered and managed. The scope of a document is any seralized
object with a mime-type, so includes formal patient centric documents (CDA), cliical notes,
scanned paper, and non-patient specific documents like policy text.
A reference to a document of any kind for any purpose. Provides metadata about the document
so that the document can be discovered and managed. The scope of a document is any seralized
object with a mime-type, so includes formal patient centric documents (CDA), cliical notes,
scanned paper, and non-patient specific documents like policy text.
If the resource is contained in another resource, it SHALL be referred to from elsewhere
in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonica
l) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(refer
ence = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(c
anonical) = '#').exists()).not()).trace('unmatched', id).empty()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:refere
nce/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
If a resource is contained in another resource, it SHALL NOT have a meta.versionId or
a meta.lastUpdated
When a resource has no narrative, only systems that fully understand the data can display
the resource to a human safely. Including a human readable representation in the resource
makes for a much more robust eco-system and cheaper handling of resources by intermediary
systems. Some ecosystems restrict distribution of resources to only those systems that
do fully understand the resources, and as a consequence implementers may believe that
the narrative is superfluous. However experience shows that such eco-systems often open
up to new participants over time.
The logical id of the resource, as used in the URL for the resource. Once assigned, this
value never changes.
The only time that a resource does not have an id is when it is being submitted to the
server using a create operation.
<!-- Note: special primitive values have a FHIRPath system type. e.g. this is compiler magic
(j) -->
The metadata about the resource. This is content that is maintained by the infrastructure.
Changes to the content might not always be associated with version changes to the resource.
A reference to a set of rules that were followed when the resource was constructed, and
which must be understood when processing the content. Often, this is a reference to an
implementation guide that defines the special rules along with other profiles etc.
Asserting this rule set restricts the content to be only understood by a limited set of
trading partners. This inherently limits the usefulness of the data in the long term.
However, the existing health eco-system is highly fractured, and not yet ready to define,
collect, and exchange data in a generally computable sense. Wherever possible, implementers
and/or specification writers should avoid using this element. Often, when used, the URL
is a reference to an implementation guide that defines these special rules as part of
it's narrative along with other profiles, value sets, etc.
This element is labeled as a modifier because the implicit rules may provide additional
knowledge about the resource that modifies it's meaning or interpretation
Language is provided to support indexing and accessibility (typically, services such as
text to speech use the language tag). The html language tag in the narrative applies
to the narrative. The language tag on the resource may be used to specify the language
of other presentations generated from the data in the resource. Not all the content has
to be in the base language. The Resource.language should not be assumed to apply to the
narrative automatically. If a language is specified, it should it also be specified on
the div element in the html (see rules in HTML5 for information about the relationship
between xml:lang and the html lang attribute).
A human-readable narrative that contains a summary of the resource and can be used to
represent the content of the resource to a human. The narrative need not encode all the
structured data, but is required to contain sufficient detail to make it "clinically
safe" 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 "text blob"
or where text is additionally entered raw or narrated and encoded information is added
later.
These resources do not have an independent existence apart from the resource that contains
them - they cannot be identified independently, and nor can they have their own independent
transaction scope.
This should never be done when the content can be identified properly, as once identification
is lost, it is extremely difficult (and context dependent) to restore it again. Contained
resources may have profiles and tags In their meta elements, but SHALL NOT have security
labels.
May be used to represent additional information that is not part of the basic definition
of the resource. To make the use of extensions safe and manageable, there is a strict
set of governance applied to the definition and use of extensions. Though any implementer
can define an extension, there is a set of requirements that SHALL be met as part of the
definition of the extension.
There can be no stigma associated with the use of extensions by any application, project,
or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
The use of extensions is what allows the FHIR specification to retain a core level of
simplicity for everyone.
May be used to represent additional information that is not part of the basic definition
of the resource and that modifies the understanding of the element that contains it and/or
the understanding of the containing element's descendants. Usually modifier elements provide
negation or qualification. To make the use of extensions safe and manageable, there is
a strict set of governance applied to the definition and use of extensions. Though any
implementer is allowed to define an extension, there is a set of requirements that SHALL
be met as part of the definition of the extension. Applications processing a resource
are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
(including cannot change the meaning of modifierExtension itself).
There can be no stigma associated with the use of extensions by any application, project,
or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
The use of extensions is what allows the FHIR specification to retain a core level of
simplicity for everyone.
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly
distinguished from the vast majority of extensions which can be safely ignored. This
promotes interoperability by eliminating the need for implementers to prohibit the presence
of extensions. For further information, see the [definition of modifier extensions](extensibility.ht
ml#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource
that contains them
Document identifier as assigned by the source of the document. This identifier is specific
to this version of the document. This unique identifier may be used elsewhere to identify
this version of the document.
The structure and format of this Id shall be consistent with the specification corresponding
to the formatCode attribute. (e.g. for a DICOM standard document a 64-character numeric
UID, for an HL7 CDA format a serialization of the CDA Document Id extension and root in
the form "oid^extension", where OID is a 64 digits max, and the Id is a 16 UTF-8
char max. If the OID is coded without the extension then the '^' character shall not be
included.).
This is the status of the DocumentReference object, which might be independent from the
docStatus element.
This element is labeled as a modifier because the status contains the codes that mark
the document or reference as not currently valid.
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
interim: .completionCode="IN" & ./statusCode[isNormalDatatype()]="active";
final: .completionCode="AU" && ./statusCode[isNormalDatatype()]="complete&q
uot; and not(./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[su
bsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("ReviseDocum
ent", code) and isNormalAct()]); amended: .completionCode="AU" &&
./statusCode[isNormalDatatype()]="complete" and ./inboundRelationship[typeCode="SUBJ
" and isNormalActRelationship()]/source[subsumesCode("ActClass#CACT") and
moodCode="EVN" and domainMember("ReviseDocument", code) and isNormalAct()
and statusCode="completed"]; withdrawn : .completionCode=NI && ./statusCode[isNo
rmalDatatype()]="obsolete"
Specifies the particular kind of document referenced (e.g. History and Physical, Discharge
Summary, Progress Note). This usually equates to the purpose of making the document referenced.
Key metadata element describing the document that describes he exact type of document.
Helps humans to assess whether the document is of interest when viewing a list of documents.
ClinicalDocument/code/@code
The typeCode should be mapped from the ClinicalDocument/code element to a set of document
type codes configured in the affinity domain. One suggested coding system to use for typeCode
is LOINC, in which case the mapping step can be omitted.
A categorization for the type of document referenced - helps for indexing and searching.
This may be implied by or derived from the code specified in the DocumentReference.type.
Key metadata element describing the the category or classification of the document. This
is a broader perspective that groups similar documents based on how they would be used.
This is a primary key used in searching.
.outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN&quo
t;].code
Derived from a mapping of /ClinicalDocument/code/@code to an Affinity Domain specified
coded value to use and coding system. Affinity Domains are encouraged to use the appropriate
value for Type of Service, based on the LOINC Type of Service (see Page 53 of the LOINC
User's Manual). Must be consistent with /ClinicalDocument/code/@code
Who or what the document is about. The document can be about a person, (patient or healthcare
practitioner), a device (e.g. a machine) or even a group of subjects (such as a document
about a herd of farm animals, or a set of patients that share a common exposure).
Represents a participant within the author institution who has legally authenticated or
attested the document. Legal authentication implies that a document has been signed manually
or electronically by the legal Authenticator.
Identifies the organization or group who is responsible for ongoing maintenance of and
access to the document.
Identifies the logical organization (software system, vendor, or department) to go to
find the current version, where to report issues, etc. This is different from the physical
location (URL, disk drive, or server) of the document, which is the technical location
of the document, which host may be delegated to the management of some other organization.
.participation[typeCode="RCV"].role[classCode="CUST"].scoper[classCode="ORG
" and determinerCode="INST"]
This element is labeled as a modifier because documents that append to other documents
are incomplete on their own.
Unique id for the element within a resource (for internal references). This may be any
string value that does not contain spaces.
<!-- Note: special primitive values have a FHIRPath system type. e.g. this is compiler magic
(j) -->
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.
A set of Security-Tag codes specifying the level of privacy/security of the Document.
Note that DocumentReference.meta.security contains the security labels of the "reference"
to the document, while DocumentReference.securityLabel contains a snapshot of the security
labels on the document the reference refers to.
The confidentiality codes can carry multiple vocabulary items. HL7 has developed an understanding
of security and privacy tags that might be desirable in a Document Sharing environment,
called HL7 Healthcare Privacy and Security Classification System (HCS). The following
specification is recommended but not mandated, as the vocabulary bindings are an administrative
domain responsibility. The use of this method is up to the policy domain such as the XDS
Affinity Domain or other Trust Domain where all parties including sender and recipients
are trusted to appropriately tag and enforce.
In the HL7 Healthcare Privacy and Security Classification (HCS) there are code systems
specific to Confidentiality, Sensitivity, Integrity, and Handling Caveats. Some values
would come from a local vocabulary as they are related to workflow roles and special projects.
Use of the Health Care Privacy/Security Classification (HCS) system of security-tag use
is recommended.
The document and format referenced. There may be multiple content element repetitions,
each with a different format.
Unique id for the element within a resource (for internal references). This may be any
string value that does not contain spaces.
<!-- Note: special primitive values have a FHIRPath system type. e.g. this is compiler magic
(j) -->
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
The document or URL of the document along with critical metadata to prove content has
integrity.
Composition.language,
Composition.title,
Composition.date
DocumentEntry.mimeType, DocumentEntry.languageCode, DocumentEntry.URI, DocumentEntry.size,
DocumentEntry.hash, DocumentEntry.title, DocumentEntry.creationTime
An identifier of the document encoding, structure, and template that the document conforms
to beyond the base format indicated in the mimeType.
Note that while IHE mostly issues URNs for format types, not all documents can be identified
by a URI.
Unique id for the element within a resource (for internal references). This may be any
string value that does not contain spaces.
<!-- Note: special primitive values have a FHIRPath system type. e.g. this is compiler magic
(j) -->
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
Describes the clinical encounter or type of care that the document content is associated
with.
unique(highest(./outboundRelationship[typeCode="SUBJ" and isNormalActRelationship()],
priorityNumber)/target[moodCode="EVN" and classCode=("ENC", "PCPR")
and isNormalAct])
This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy,
being documented. In some cases, the event is inherent in the type Code, such as a "History
and Physical Report" in which the procedure being documented is necessarily a "History
and Physical" act.
An event can further specialize the act inherent in the type, such as where it is simply
"Procedure Report" and the procedure was a "colonoscopy". If one or
more event codes are included, they shall not conflict with the values inherent in the
class or type elements as such a conflict would create an ambiguous situation.
ClinicalDocument/documentationOf/
serviceEvent/effectiveTime/low/
@value --> ClinicalDocument/documentationOf/
serviceEvent/effectiveTime/high/
@value
This property may convey specifics about the practice setting where the content was created,
often reflecting the clinical specialty.
This element should be based on a coarse classification system for the class of specialty
practice. Recommend the use of the classification system for Practice Setting, such as
that described by the Subject Matter Domain in LOINC.
This is an important piece of metadata that providers often rely upon to quickly sort
and/or filter out to find specific content.
The Patient Information as known when the document was published. May be a reference to
a version specific, or contained.
May be identifiers or resources that caused the DocumentReference or referenced Document
to be created.
./outboundRelationship[typeCode="PERT" and isNormalActRelationship()] / target[isNormalAct
]
A reference to a document of any kind for any purpose. Provides metadata about the document
so that the document can be discovered and managed. The scope of a document is any seralized
object with a mime-type, so includes formal patient centric documents (CDA), cliical notes,
scanned paper, and non-patient specific documents like policy text.
Document identifier as assigned by the source of the document. This identifier is specific
to this version of the document. This unique identifier may be used elsewhere to identify
this version of the document.
The structure and format of this Id shall be consistent with the specification corresponding
to the formatCode attribute. (e.g. for a DICOM standard document a 64-character numeric
UID, for an HL7 CDA format a serialization of the CDA Document Id extension and root in
the form "oid^extension", where OID is a 64 digits max, and the Id is a 16 UTF-8
char max. If the OID is coded without the extension then the '^' character shall not be
included.).
This is the status of the DocumentReference object, which might be independent from the
docStatus element.
This element is labeled as a modifier because the status contains the codes that mark
the document or reference as not currently valid.
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
interim: .completionCode="IN" & ./statusCode[isNormalDatatype()]="active";
final: .completionCode="AU" && ./statusCode[isNormalDatatype()]="complete&q
uot; and not(./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[su
bsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("ReviseDocum
ent", code) and isNormalAct()]); amended: .completionCode="AU" &&
./statusCode[isNormalDatatype()]="complete" and ./inboundRelationship[typeCode="SUBJ
" and isNormalActRelationship()]/source[subsumesCode("ActClass#CACT") and
moodCode="EVN" and domainMember("ReviseDocument", code) and isNormalAct()
and statusCode="completed"]; withdrawn : .completionCode=NI && ./statusCode[isNo
rmalDatatype()]="obsolete"
Specifies the particular kind of document referenced (e.g. History and Physical, Discharge
Summary, Progress Note). This usually equates to the purpose of making the document referenced.
Key metadata element describing the document that describes he exact type of document.
Helps humans to assess whether the document is of interest when viewing a list of documents.
ClinicalDocument/code/@code
The typeCode should be mapped from the ClinicalDocument/code element to a set of document
type codes configured in the affinity domain. One suggested coding system to use for typeCode
is LOINC, in which case the mapping step can be omitted.
A categorization for the type of document referenced - helps for indexing and searching.
This may be implied by or derived from the code specified in the DocumentReference.type.
Key metadata element describing the the category or classification of the document. This
is a broader perspective that groups similar documents based on how they would be used.
This is a primary key used in searching.
.outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN&quo
t;].code
Derived from a mapping of /ClinicalDocument/code/@code to an Affinity Domain specified
coded value to use and coding system. Affinity Domains are encouraged to use the appropriate
value for Type of Service, based on the LOINC Type of Service (see Page 53 of the LOINC
User's Manual). Must be consistent with /ClinicalDocument/code/@code
Who or what the document is about. The document can be about a person, (patient or healthcare
practitioner), a device (e.g. a machine) or even a group of subjects (such as a document
about a herd of farm animals, or a set of patients that share a common exposure).
Represents a participant within the author institution who has legally authenticated or
attested the document. Legal authentication implies that a document has been signed manually
or electronically by the legal Authenticator.
Identifies the organization or group who is responsible for ongoing maintenance of and
access to the document.
Identifies the logical organization (software system, vendor, or department) to go to
find the current version, where to report issues, etc. This is different from the physical
location (URL, disk drive, or server) of the document, which is the technical location
of the document, which host may be delegated to the management of some other organization.
.participation[typeCode="RCV"].role[classCode="CUST"].scoper[classCode="ORG
" and determinerCode="INST"]
This element is labeled as a modifier because documents that append to other documents
are incomplete on their own.
If this document appends another document, then the document cannot be fully understood
without also accessing the referenced document.
A set of Security-Tag codes specifying the level of privacy/security of the Document.
Note that DocumentReference.meta.security contains the security labels of the "reference"
to the document, while DocumentReference.securityLabel contains a snapshot of the security
labels on the document the reference refers to.
The confidentiality codes can carry multiple vocabulary items. HL7 has developed an understanding
of security and privacy tags that might be desirable in a Document Sharing environment,
called HL7 Healthcare Privacy and Security Classification System (HCS). The following
specification is recommended but not mandated, as the vocabulary bindings are an administrative
domain responsibility. The use of this method is up to the policy domain such as the XDS
Affinity Domain or other Trust Domain where all parties including sender and recipients
are trusted to appropriately tag and enforce.
In the HL7 Healthcare Privacy and Security Classification (HCS) there are code systems
specific to Confidentiality, Sensitivity, Integrity, and Handling Caveats. Some values
would come from a local vocabulary as they are related to workflow roles and special projects.
Use of the Health Care Privacy/Security Classification (HCS) system of security-tag use
is recommended.
The document and format referenced. There may be multiple content element repetitions,
each with a different format.
The document or URL of the document along with critical metadata to prove content has
integrity.
Composition.language,
Composition.title,
Composition.date
DocumentEntry.mimeType, DocumentEntry.languageCode, DocumentEntry.URI, DocumentEntry.size,
DocumentEntry.hash, DocumentEntry.title, DocumentEntry.creationTime
An identifier of the document encoding, structure, and template that the document conforms
to beyond the base format indicated in the mimeType.
Note that while IHE mostly issues URNs for format types, not all documents can be identified
by a URI.
Describes the clinical encounter or type of care that the document content is associated
with.
unique(highest(./outboundRelationship[typeCode="SUBJ" and isNormalActRelationship()],
priorityNumber)/target[moodCode="EVN" and classCode=("ENC", "PCPR")
and isNormalAct])
This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy,
being documented. In some cases, the event is inherent in the type Code, such as a "History
and Physical Report" in which the procedure being documented is necessarily a "History
and Physical" act.
An event can further specialize the act inherent in the type, such as where it is simply
"Procedure Report" and the procedure was a "colonoscopy". If one or
more event codes are included, they shall not conflict with the values inherent in the
class or type elements as such a conflict would create an ambiguous situation.
ClinicalDocument/documentationOf/
serviceEvent/effectiveTime/low/
@value --> ClinicalDocument/documentationOf/
serviceEvent/effectiveTime/high/
@value
This property may convey specifics about the practice setting where the content was created,
often reflecting the clinical specialty.
This element should be based on a coarse classification system for the class of specialty
practice. Recommend the use of the classification system for Practice Setting, such as
that described by the Subject Matter Domain in LOINC.
This is an important piece of metadata that providers often rely upon to quickly sort
and/or filter out to find specific content.
The Patient Information as known when the document was published. May be a reference to
a version specific, or contained.
May be identifiers or resources that caused the DocumentReference or referenced Document
to be created.
./outboundRelationship[typeCode="PERT" and isNormalActRelationship()] / target[isNormalAct
]
<?xml version="1.0" encoding="UTF-8"?>
<StructureDefinition xmlns="http://hl7.org/fhir"> <id value="DocumentReference"/> <meta> <lastUpdated value="2025-12-18T07:07:42.170+11:00"/> </meta> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align:
top;">
<tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align:
top">
<th class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom:
3px">
<a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a> </th> <th class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom:
3px">
<a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a> </th> <th class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom:
3px">
<a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the element can appear in the instance">Card.</a> </th> <th class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom:
3px; width: 100px">
<a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a> </th> <th class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom:
3px">
<a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description & Constraints</a> <span style="float: right"> <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"> <img alt="doco" src="data:(snipped in html view)" style="background-color: inherit"/> </a> </span> </th> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAJUlEQVR4Xu3IIQEAAAg
DsHd9/w4EQIOamFnaBgAA4MMKAACAKwNp30CqZFfFmwAAAABJRU5ErkJggg==)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Resource"/> <span title="DocumentReference : A reference to a document of any kind for any purpose. While
the term “document” implies a more narrow focus, for this resource this "document"
encompasses *any* serialized object with a mime-type, it includes formal patient-centric
documents (CDA), clinical notes, scanned paper, non-patient specific documents
like policy text, as well as a photo, video, or audio recording acquired or used
in healthcare. The DocumentReference resource provides metadata about the document
so that the document can be discovered and managed. The actual content may be
inline base64 encoded data or provided by direct reference.">DocumentReference</span>
<a name="DocumentReference"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="versions.html#std-process" style="padding-left: 3px; padding-right: 3px; border: 1px grey solid; font-weight: bold;
color: black; background-color: #e6ffe6; padding-left: 3px; padding-right: 3px;
border: 1px grey solid; font-weight: bold; color: black; background-color: #e6ffe6" title="Standards Status = Normative">N</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="domainresource.html">DomainResource</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">A reference to a document
<br/> <span style="font-style: italic" title="docRef-1">+ Warning: facilityType SHALL only be present if context is not an encounter</span> <br/> <span style="font-style: italic" title="docRef-2">+ Warning: practiceSetting SHALL only be present if context is not present</span> <br/> <br/> Elements defined in Ancestors: <a href="resource.html#Resource" title="The logical id of the resource, as used in the URL for the resource. Once assigned,
this value never changes.">id</a> ,
<a href="resource.html#Resource" title="The metadata about the resource. This is content that is maintained by the infrastructure.
Changes to the content might not always be associated with version changes to the
resource.">meta</a> ,
<a href="resource.html#Resource" title="A reference to a set of rules that were followed when the resource was constructed,
and which must be understood when processing the content. Often, this is a reference
to an implementation guide that defines the special rules along with other profiles
etc. For DomainResources, if more than one implicitRules policy applies, additional
policies may be conveyed using the [additionalImplicitRules](https://build.fhir.org/ig/HL7/fh
ir-extensions/StructureDefinition-additionalImplicitRules.html) extension.">implicitRules</a> ,
<a href="resource.html#Resource" title="The base language in which the resource is written.">language</a> , <a href="domainresource.html#DomainResource" title="A human-readable narrative that contains a summary of the resource and can be used
to represent the content of the resource to a human. The narrative need not encode
all the structured data, but is required to contain sufficient detail to make it
"clinically safe" for a human to just read the narrative. Resource definitions
may define what content should be represented in the narrative to ensure clinical
safety.">text</a> ,
<a href="domainresource.html#DomainResource" title="These resources do not have an independent existence apart from the resource that
contains them - they cannot be identified independently, nor can they have their
own independent transaction scope. This is allowed to be a Parameters resource
if and only if it is referenced by a resource that provides context/meaning.">contained</a> ,
<a href="domainresource.html#DomainResource" title="May be used to represent additional information that is not part of the basic definition
of the resource. To make the use of extensions safe and managable, there is a strict
set of governance applied to the definition and use of extensions. Though any implementer
can define an extension, there is a set of requirements that SHALL be met as part
of the definition of the extension.">extension</a> ,
<a href="domainresource.html#DomainResource" title="May be used to represent additional information that is not part of the basic definition
of the resource and that modifies the understanding of the element that contains
it and/or the understanding of the containing element's descendants. Usually modifier
elements provide negation or qualification. To make the use of extensions safe
and managable, there is a strict set of governance applied to the definition and
use of extensions. Though any implementer is allowed to define an extension, there
is a set of requirements that SHALL be met as part of the definition of the extension.
Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or
DomainResource (including cannot change the meaning of modifierExtension itself).">modifierExtension</a>
</td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Data Type"/> <span title="DocumentReference.identifier : Business identifiers assigned to this document reference
by the performer and/or other systems. These identifiers remain constant as the
resource is updated and propagates from server to server.">identifier</span>
<a name="DocumentReference.identifier"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#Identifier">Identifier</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Business identifiers for the document
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="DocumentReference.version : An explicitly assigned identifier of a variation of
the content in the DocumentReference.">version</span>
<a name="DocumentReference.version"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#string">string</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">An explicitly assigned identifier of a variation of the content in the DocumentReference
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource"/> <span title="DocumentReference.basedOn : A procedure that is fulfilled in whole or in part by
the creation of this media.">basedOn</span>
<a name="DocumentReference.basedOn"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="references.html#Reference">Reference</a> ( <a href="appointment.html">Appointment</a> | <a href="appointmentresponse.html">AppointmentResponse</a> | <a href="careplan.html">CarePlan</a> | <a href="claim.html">Claim</a> | <a href="communicationrequest.html">CommunicationRequest</a> | <a href="contract.html">Contract</a> | <a href="coverageeligibilityrequest.html">CoverageEligibilityRequest</a> | <a href="devicerequest.html">DeviceRequest</a> | <a href="enrollmentrequest.html">EnrollmentRequest</a> | <a href="medicationrequest.html">MedicationRequest</a> | <a href="nutritionorder.html">NutritionOrder</a> | <a href="requestorchestration.html">RequestOrchestration</a> | <a href="servicerequest.html">ServiceRequest</a> | <a href="visionprescription.html">VisionPrescription</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Procedure that caused this media to be created
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="DocumentReference.status : The current state of the document reference.">status</span> <a name="DocumentReference.status"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="conformance-rules.html#isModifier" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is a modifier element">?!</a>
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">1..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#code">code</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">current | superseded | entered-in-error
<br/> Binding: <a href="valueset-document-reference-status.html">DocumentReferenceStatus</a> ( <a href="terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value
set.">Required</a> )
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/> <span title="DocumentReference.docStatus : The status of the underlying document.">docStatus</span> <a name="DocumentReference.docStatus"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="conformance-rules.html#isModifier" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is a modifier element">?!</a>
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#code">code</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">registered | partial | preliminary | final | amended | corrected | appended | cancelled
| entered-in-error | deprecated | unknown
<br/> Binding: <a href="valueset-composition-status.html">Composition Status</a> ( <a href="terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value
set.">Required</a> )
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="DocumentReference.modality : Imaging modality used. This may include both acquisition
and non-acquisition modalities.">modality</span>
<a name="DocumentReference.modality"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#CodeableConcept">CodeableConcept</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Imaging modality used
<br/> Binding: <a href="http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_33.html">Modality</a> ( <a href="terminologies.html#extensible" title="To be conformant, the concept in this element SHALL be from the specified value
set if any of the codes within the value set can apply to the concept being communicated.
If the value set does not cover the concept (based on human review), alternate
codings (or, data type allowing, text) may be included instead.">Extensible</a> )
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Data Type"/> <span title="DocumentReference.type : Specifies the particular kind of document referenced
(e.g. History and Physical, Discharge Summary, Progress Note). This usually equates
to the purpose of making the document referenced.">type</span>
<a name="DocumentReference.type"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#CodeableConcept">CodeableConcept</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Kind of document (LOINC if possible)
<br/> Binding: <a href="valueset-doc-typecodes.html">FHIR Document Type Codes</a> ( <a href="terminologies.html#preferred" title="Instances are encouraged to draw from the specified codes for interoperability
purposes but are not required to do so to be considered conformant.">Preferred</a> )
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="DocumentReference.category : A categorization for the type of document referenced
- helps for indexing and searching. This may be implied by or derived from the
code specified in the DocumentReference.type.">category</span>
<a name="DocumentReference.category"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#CodeableConcept">CodeableConcept</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Categorization of document
<br/> Binding: <a href="valueset-referenced-item-category.html">Referenced Item Category Value Set</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
set. The value set merely provides examples of the types of concepts intended
to be included.">Example</a> )
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource"/> <span title="DocumentReference.subject : Who or what the document is about. The document can
be about a person, (patient or healthcare practitioner), a device (e.g. a machine)
or even a group of subjects (such as a document about a herd of farm animals, or
a set of patients that share a common exposure).">subject</span>
<a name="DocumentReference.subject"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="references.html#Reference">Reference</a> ( <a href="resourcelist.html">Any</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Who/what is the subject of the document
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="DocumentReference.context : The Encounter during which this document reference
was created or to which the creation of this record is tightly associated.">context</span>
<a name="DocumentReference.context"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
<a href="conformance-rules.html#constraints" style="padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold;
color: #301212; background-color: #fdf4f4;; padding-left: 3px; padding-right: 3px;
border: 1px maroon solid; font-weight: bold; color: #301212; background-color:
#fdf4f4;" title="This element has or is affected by some invariants">C</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="references.html#Reference">Reference</a> ( <a href="appointment.html">Appointment</a> | <a href="encounter.html">Encounter</a> | <a href="episodeofcare.html">EpisodeOfCare</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Encounter the document reference is part of
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource"/> <span title="DocumentReference.event : This list of codes represents the main clinical acts,
such as a colonoscopy or an appendectomy, being documented. In some cases, the
event is inherent in the type Code, such as a "History and Physical Report"
in which the procedure being documented is necessarily a "History and Physical"
act.">event</span>
<a name="DocumentReference.event"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="references.html#CodeableReference">CodeableReference</a> ( <a href="resourcelist.html">Any</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Main clinical acts documented
<br/> Binding: <a href="http://terminology.hl7.org/7.0.1/ValueSet-v3-ActCode.html">v3 Code System ActCode</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
set. The value set merely provides examples of the types of concepts intended
to be included.">Example</a> )
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="DocumentReference.related : Any other resource this document reference was created
or to which the creation of this record is tightly associated.">related</span>
<a name="DocumentReference.related"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="references.html#Reference">Reference</a> ( <a href="resourcelist.html">Any</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Related identifiers or resources associated with the document reference
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource"/> <span title="DocumentReference.bodyStructure : The anatomic structures included in the document.">bodyStructure</span> <a name="DocumentReference.bodyStructure"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="references.html#CodeableReference">CodeableReference</a> ( <a href="bodystructure.html">BodyStructure</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Body structure included
<br/> Binding: <a href="valueset-body-site.html" title="Codes describing anatomical body structures. May include laterality.">SNOMED CT Body Structures</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
set. The value set merely provides examples of the types of concepts intended
to be included.">Example</a> )
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="DocumentReference.facilityType : The kind of facility where the patient was seen.">facilityType</span> <a name="DocumentReference.facilityType"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="conformance-rules.html#constraints" style="padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold;
color: #301212; background-color: #fdf4f4;; padding-left: 3px; padding-right: 3px;
border: 1px maroon solid; font-weight: bold; color: #301212; background-color:
#fdf4f4;" title="This element has or is affected by some invariants">C</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#CodeableConcept">CodeableConcept</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Kind of facility where patient was seen
<br/> Binding: <a href="valueset-c80-facilitycodes.html">Facility Type Code Value Set</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
set. The value set merely provides examples of the types of concepts intended
to be included.">Example</a> )
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Data Type"/> <span title="DocumentReference.practiceSetting : This property may convey specifics about the
practice setting where the content was created, often reflecting the clinical specialty.">practiceSetting</span>
<a name="DocumentReference.practiceSetting"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="conformance-rules.html#constraints" style="padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold;
color: #301212; background-color: #fdf4f4;; padding-left: 3px; padding-right: 3px;
border: 1px maroon solid; font-weight: bold; color: #301212; background-color:
#fdf4f4;" title="This element has or is affected by some invariants">C</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#CodeableConcept">CodeableConcept</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Additional details about where the content was created (e.g. clinical specialty)
<br/> Binding: <a href="valueset-c80-practice-codes.html">Practice Setting Code Value Set</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
set. The value set merely provides examples of the types of concepts intended
to be included.">Example</a> )
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="DocumentReference.period : The time period over which the service that is described
by the document was provided.">period</span>
<a name="DocumentReference.period"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#Period">Period</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Time of service that is being documented
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/> <span title="DocumentReference.date : When the document reference was created.">date</span> <a name="DocumentReference.date"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#dateTime">dateTime</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">When this document reference was created
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="DocumentReference.author : Identifies who is responsible for adding the information
to the document.">author</span>
<a name="DocumentReference.author"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="references.html#Reference">Reference</a> ( <a href="practitioner.html">Practitioner</a> | <a href="practitionerrole.html">PractitionerRole</a> | <a href="organization.html">Organization</a> | <a href="device.html">Device</a> | <a href="patient.html">Patient</a> | <a href="relatedperson.html">RelatedPerson</a> | <a href="careteam.html">CareTeam</a> | <a href="group.html">Group</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Who and/or what authored the document
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Element"/> <span title="DocumentReference.attester : A participant who has authenticated the accuracy of
the document.">attester</span>
<a name="DocumentReference.attester"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="types.html#BackBoneElement">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Attests to accuracy of the document
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAMUlEQVR4Xu3LMQoAIBA
Dwftr/v8GtdbqEAthAtMspJJUx9rYW8ftHwAA+NcRAAAAXplLq0BWj/rZigAAAABJRU5ErkJggg==)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="DocumentReference.attester.mode : The type of attestation the authenticator offers.">mode</span> <a name="DocumentReference.attester.mode"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">1..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#CodeableConcept">CodeableConcept</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">personal | professional | legal | official
<br/> Binding: <a href="valueset-composition-attestation-mode.html">Composition Attestation Mode</a> ( <a href="terminologies.html#preferred" title="Instances are encouraged to draw from the specified codes for interoperability
purposes but are not required to do so to be considered conformant.">Preferred</a> )
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAMUlEQVR4Xu3LMQoAIBA
Dwftr/v8GtdbqEAthAtMspJJUx9rYW8ftHwAA+NcRAAAAXplLq0BWj/rZigAAAABJRU5ErkJggg==)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/> <span title="DocumentReference.attester.time : When the document was attested by the party.">time</span> <a name="DocumentReference.attester.time"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#dateTime">dateTime</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">When the document was attested
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="DocumentReference.attester.party : Who attested the document in the specified way.">party</span> <a name="DocumentReference.attester.party"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="references.html#Reference">Reference</a> ( <a href="patient.html">Patient</a> | <a href="relatedperson.html">RelatedPerson</a> | <a href="practitioner.html">Practitioner</a> | <a href="practitionerrole.html">PractitionerRole</a> | <a href="organization.html">Organization</a> | <a href="group.html">Group</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Who attested the document
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource"/> <span title="DocumentReference.custodian : Identifies the organization or group who is responsible
for ongoing maintenance of and access to the document.">custodian</span>
<a name="DocumentReference.custodian"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="references.html#Reference">Reference</a> ( <a href="organization.html">Organization</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Organization which maintains the document
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Element"/> <span title="DocumentReference.relatesTo : Relationships that this document has with other document
references that already exist.">relatesTo</span>
<a name="DocumentReference.relatesTo"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="types.html#BackBoneElement">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Relationships to other documents
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAMUlEQVR4Xu3LMQoAIBA
Dwftr/v8GtdbqEAthAtMspJJUx9rYW8ftHwAA+NcRAAAAXplLq0BWj/rZigAAAABJRU5ErkJggg==)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Data Type"/> <span title="DocumentReference.relatesTo.code : The type of relationship that this document
has with anther document.">code</span>
<a name="DocumentReference.relatesTo.code"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">1..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#CodeableConcept">CodeableConcept</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">The relationship type with another document
<br/> Binding: <a href="valueset-document-relationship-type.html">Document Relationship Type</a> ( <a href="terminologies.html#extensible" title="To be conformant, the concept in this element SHALL be from the specified value
set if any of the codes within the value set can apply to the concept being communicated.
If the value set does not cover the concept (based on human review), alternate
codings (or, data type allowing, text) may be included instead.">Extensible</a> )
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="DocumentReference.relatesTo.target : The target document of this relationship.">target</span> <a name="DocumentReference.relatesTo.target"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">1..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="references.html#Reference">Reference</a> ( <a href="documentreference.html">DocumentReference</a> ) </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Target of the relationship
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/> <span title="DocumentReference.description : Human-readable description of the source document.">description</span> <a name="DocumentReference.description"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#markdown">markdown</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Human-readable description
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="DocumentReference.securityLabel : A set of Security-Tag codes specifying the level
of privacy/security of the Document found at DocumentReference.content.attachment.url.
Note that DocumentReference.meta.security contains the security labels of the data
elements in DocumentReference, while DocumentReference.securityLabel contains the
security labels for the document the reference refers to. The distinction recognizes
that the document may contain sensitive information, while the DocumentReference
is metadata about the document and thus might not be as sensitive as the document.
For example: a psychotherapy episode may contain highly sensitive information,
while the metadata may simply indicate that some episode happened.">securityLabel</span>
<a name="DocumentReference.securityLabel"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#CodeableConcept">CodeableConcept</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Document security-tags
<br/> Binding: <a href="valueset-security-label-example.html">Example set of Security Labels</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
set. The value set merely provides examples of the types of concepts intended
to be included.">Example</a> )
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAJUlEQVR4Xu3IIQEAAAg
DsHd9/w4EQIOamFnaBgAA4MMKAACAKwNp30CqZFfFmwAAAABJRU5ErkJggg==)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Element"/> <span title="DocumentReference.content : The document and format referenced. If there are multiple
content element repetitions, these must all represent the same document in different
format, or attachment metadata.">content</span>
<a name="DocumentReference.content"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">1..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="types.html#BackBoneElement">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Document referenced
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAw
Esez6+89AqKGGJj7JzVWS+mm3zgcAAMxwDQAAgFcaYAVAgNGLTjgAAAAASUVORK5CYII=)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="DocumentReference.content.attachment : The document or URL of the document along
with critical metadata to prove content has integrity.">attachment</span>
<a name="DocumentReference.content.attachment"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">1..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#Attachment">Attachment</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Where to access the document
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAJUlEQVR4Xu3IIQEAAAg
DsHd9/w4EQIOamFnaBgAA4MMKAACAKwNp30CqZFfFmwAAAABJRU5ErkJggg==)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Element"/> <span title="DocumentReference.content.profile : An identifier of the document constraints,
encoding, structure, and template that the document conforms to beyond the base
format indicated in the mimeType.">profile</span>
<a name="DocumentReference.content.profile"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="types.html#BackBoneElement">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Content profile rules for the document
<br/> <br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAw
Esez6+89AqKGGJj7JzVWSmmS3zgcAAPxxDQAAgFcadQVAgPvMVYYAAAAASUVORK5CYII=)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Choice of Types"/> <span title="DocumentReference.content.profile.value[x] : Code|uri|canonical.">value[x]</span> <a name="DocumentReference.content.profile.value_x_"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null; padding-left: 3px; padding-right:
3px; color: black; null" title="This element is included in summaries">Σ</a>
</td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">1..1</td>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">Code|uri|canonical
<br/> Binding: <a href="http://terminology.hl7.org/7.0.1/ValueSet-v3-HL7FormatCodes.html">HL7 ValueSet of Format Codes for use with Document Sharing</a> ( <a href="terminologies.html#preferred" title="Instances are encouraged to draw from the specified codes for interoperability
purposes but are not required to do so to be considered conformant.">Preferred</a> )
<br/> </td> </tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAw
Esez6+89AqKGGJj7JzVWSmmS3zgcAAPxxDQAAgFcadQVAgPvMVYYAAAAASUVORK5CYII=)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Data Type"/> <span title="A reference to a code defined by a terminology system.">valueCoding</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/>
</tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
white">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAw
Esez6+89AqKGGJj7JzVWSmmS3zgcAAPxxDQAAgFcadQVAgPvMVYYAAAAASUVORK5CYII=)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="String of characters used to identify a name or a resource">valueUri</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#uri">uri</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: white;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/>
</tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
#F7F7F7">
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAJUlEQVR4Xu3IIQEAAAg
DsHd9/w4EQIOamFnaBgAA4MMKAACAKwNp30CqZFfFmwAAAABJRU5ErkJggg==)">
<img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource"/> valueCanonical </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/>
<td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px">
<a href="datatypes.html#canonical">canonical</a> () </td> <td class="hierarchy" style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7;
border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px"/>
</tr> <tr> <td class="hierarchy" colspan="5"> <br/> <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"> <img alt="doco" src="data:(snipped in html view)" style="background-color: inherit"/> Documentation for this format </a> </td> </tr> </table> </div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-category"> <valueString value="Foundation.Documents"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"> <valueCode value="normative"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="oo"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"> <valueInteger value="5"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category"> <valueCode value="not-classified"/> </extension> <url value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/> <version value="6.0.0-ballot4"/> <name value="DocumentReference"/> <status value="active"/> <experimental value="false"/> <date value="2025-12-18T07:07:42+11:00"/> <publisher value="HL7 International / Orders and Observations"/> <contact> <telecom> <system value="url"/> <value value="http://www.hl7.org/Special/committees/fiwg"/> </telecom> </contact> <contact> <telecom> <system value="url"/> <value value="http://www.hl7.org/Special/committees/orders"/> </telecom> </contact> <description value="A reference to a document of any kind for any purpose. While the term “document”
implies a more narrow focus, for this resource this “document” encompasses *any*
serialized object with a mime-type, it includes formal patient-centric documents
(CDA), clinical notes, scanned paper, non-patient specific documents like policy
text, as well as a photo, video, or audio recording acquired or used in healthcare.
The DocumentReference resource provides metadata about the document so that the
document can be discovered and managed. The actual content may be inline base64
encoded data or provided by direct reference."/>
<jurisdiction> <coding> <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/> <code value="001"/> <display value="World"/> </coding> </jurisdiction> <fhirVersion value="6.0.0-ballot4"/> <mapping> <identity value="workflow"/> <uri value="http://hl7.org/fhir/workflow"/> <name value="Workflow Pattern"/> </mapping> <mapping> <identity value="w5"/> <uri value="http://hl7.org/fhir/fivews"/> <name value="FiveWs Pattern Mapping"/> </mapping> <mapping> <identity value="rim"/> <uri value="http://hl7.org/v3"/> <name value="RIM Mapping"/> </mapping> <mapping> <identity value="fhircomposition"/> <uri value="http://hl7.org/fhir/composition"/> <name value="FHIR Composition"/> </mapping> <mapping> <identity value="xds"/> <uri value="https://profiles.ihe.net/ITI/TF/Volume3"/> <name value="XDS metadata equivalent"/> </mapping> <mapping> <identity value="cda"/> <uri value="http://hl7.org/v3/cda"/> <name value="CDA (R2)"/> </mapping> <mapping> <identity value="v2"/> <uri value="http://hl7.org/v2"/> <name value="HL7 V2 Mapping"/> </mapping> <kind value="resource"/> <abstract value="false"/> <type value="DocumentReference"/> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> <derivation value="specialization"/> <snapshot> <element id="DocumentReference"> <path value="DocumentReference"/> <short value="A reference to a document"/> <definition value="A reference to a document of any kind for any purpose. While the term “document”
implies a more narrow focus, for this resource this "document" encompasses
*any* serialized object with a mime-type, it includes formal patient-centric documents
(CDA), clinical notes, scanned paper, non-patient specific documents like policy
text, as well as a photo, video, or audio recording acquired or used in healthcare.
The DocumentReference resource provides metadata about the document so that the
document can be discovered and managed. The actual content may be inline base64
encoded data or provided by direct reference."/>
<comment value="Usually, this is used for documents other than those defined by FHIR."/> <min value="0"/> <max value="*"/> <base> <path value="DocumentReference"/> <min value="0"/> <max value="*"/> </base> <constraint> <key value="docRef-1"/> <severity value="warning"/> <human value="facilityType SHALL only be present if context is not an encounter"/> <expression value="facilityType.empty() or context.where(resolve() is Encounter).empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/> </constraint> <constraint> <key value="docRef-2"/> <severity value="warning"/> <human value="practiceSetting SHALL only be present if context is not present"/> <expression value="practiceSetting.empty() or context.where(resolve() is Encounter).empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/> </constraint> <constraint> <key value="dom-2"/> <severity value="error"/> <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> <expression value="contained.contained.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-3"/> <severity value="error"/> <human value="If the resource is contained in another resource, it SHALL be referred to from
elsewhere in the resource or SHALL refer to the containing resource"/>
<expression value="contained.where((('#'+id.trace('id') in %resource.descendants().select(reference
| as(uri))) or descendants().where(reference='#' | as(uri)='#').exists()).not()).trace('unmat
ched', id).empty()"/>
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-4"/> <severity value="error"/> <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId
or a meta.lastUpdated"/>
<expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-5"/> <severity value="error"/> <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/> <expression value="contained.meta.security.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation"> <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can
display the resource to a human safely. Including a human readable representation
in the resource makes for a much more robust eco-system and cheaper handling of
resources by intermediary systems. Some ecosystems restrict distribution of resources
to only those systems that do fully understand the resources, and as a consequence
implementers may believe that the narrative is superfluous. However experience
shows that such eco-systems often open up to new participants over time."/>
</extension> <key value="dom-6"/> <severity value="warning"/> <human value="A resource should have narrative for robust management"/> <expression value="text.`div`.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Entity, Role, or Act,Document[classCode="DOC" and moodCode="EVN"]"/> </mapping> <mapping> <identity value="workflow"/> <map value="Event"/> </mapping> <mapping> <identity value="w5"/> <map value="infrastructure.documents"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="when describing a Composition"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry"/> </mapping> <mapping> <identity value="cda"/> <map value="when describing a CDA"/> </mapping> </element> <element id="DocumentReference.id"> <path value="DocumentReference.id"/> <short value="Logical id of this artifact"/> <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned,
this value never changes."/>
<comment value="Within the context of the FHIR RESTful interactions, the resource has an id except
for cases like the create and conditional update. Otherwise, the use of the resouce
id depends on the given use case."/>
<min value="0"/> <max value="1"/> <base> <path value="Resource.id"/> <min value="0"/> <max value="1"/> </base>
<type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="DocumentReference.meta"> <path value="DocumentReference.meta"/> <short value="Metadata about the resource"/> <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
Changes to the content might not always be associated with version changes to the
resource."/>
<min value="0"/> <max value="1"/> <base> <path value="Resource.meta"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Meta"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="DocumentReference.implicitRules"> <path value="DocumentReference.implicitRules"/> <short value="A set of rules under which this content was created"/> <definition value="A reference to a set of rules that were followed when the resource was constructed,
and which must be understood when processing the content. Often, this is a reference
to an implementation guide that defines the special rules along with other profiles
etc. For DomainResources, if more than one implicitRules policy applies, additional
policies may be conveyed using the [additionalImplicitRules](https://build.fhir.org/ig/HL7/fh
ir-extensions/StructureDefinition-additionalImplicitRules.html) extension."/>
<comment value="Asserting this rule set restricts the content to be only understood by a limited
set of trading partners. This inherently limits the usefulness of the data in the
long term. However, the existing health eco-system is highly fractured, and not
yet ready to define, collect, and exchange data in a generally computable sense.
Wherever possible, implementers and/or specification writers should avoid using
this element. Often, when used, the URL is a reference to an implementation guide
that defines these special rules as part of its narrative along with other profiles,
value sets, etc."/>
<min value="0"/> <max value="1"/> <base> <path value="Resource.implicitRules"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional
knowledge about the resource that modifies its meaning or interpretation"/>
<isSummary value="true"/> </element> <element id="DocumentReference.language"> <path value="DocumentReference.language"/> <short value="Language of the resource content"/> <definition value="The base language in which the resource is written."/> <comment value="Language is provided to support indexing and accessibility (typically, services
such as text to speech use the language tag). The html language tag in the narrative
applies to the narrative. The language tag on the resource may be used to specify
the language of other presentations generated from the data in the resource. Not
all the content has to be in the base language. The Resource.language should not
be assumed to apply to the narrative automatically. If a language is specified,
it should it also be specified on the div element in the html (see rules in HTML5
for information about the relationship between xml:lang and the html lang attribute)."/>
<min value="0"/> <max value="1"/> <base> <path value="Resource.language"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Language"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="required"/> <description value="IETF language tag for a human language"/> <valueSet value="http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot4"/> <additional> <purpose value="starter"/> <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> </additional> </binding> </element> <element id="DocumentReference.text"> <path value="DocumentReference.text"/> <short value="Text summary of the resource, for human interpretation"/> <definition value="A human-readable narrative that contains a summary of the resource and can be used
to represent the content of the resource to a human. The narrative need not encode
all the structured data, but is required to contain sufficient detail to make it
"clinically safe" 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 "text blob" or where text is additionally entered raw or narrated
and encoded information is added later."/>
<alias value="narrative"/> <alias value="html"/> <alias value="xhtml"/> <alias value="display"/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Narrative"/> </type> <condition value="dom-6"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > 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="DocumentReference.contained"> <path value="DocumentReference.contained"/> <short value="Contained, inline Resources"/> <definition value="These resources do not have an independent existence apart from the resource that
contains them - they cannot be identified independently, nor can they have their
own independent transaction scope. This is allowed to be a Parameters resource
if and only if it is referenced by a resource that provides context/meaning."/>
<comment value="This should never be done when the content can be identified properly, as once
identification is lost, it is extremely difficult (and context dependent) to restore
it again. Contained resources may have profiles and tags in their meta elements,
but SHALL NOT have security labels. Contained resources may be a resource type
defined in the FHIR specification, or an [additional resource](resource.html#additional)."/>
<alias value="inline resources"/> <alias value="anonymous resources"/> <alias value="contained resources"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.contained"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Resource"/> </type> <condition value="dom-2"/> <condition value="dom-4"/> <condition value="dom-3"/> <condition value="dom-5"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="DocumentReference.extension"> <path value="DocumentReference.extension"/> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition
of the resource. To make the use of extensions safe and managable, there is a strict
set of governance applied to the definition and use of extensions. Though any implementer
can define an extension, there is a set of requirements that SHALL be met as part
of the definition of the extension."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="DocumentReference.modifierExtension"> <path value="DocumentReference.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 managable, there is a strict set of governance applied to the definition and
use of extensions. Though any implementer is allowed to define an extension, there
is a set of requirements that SHALL be met as part of the definition of the extension.
Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or
DomainResource (including cannot change the meaning of modifierExtension itself)."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
clearly distinguished from the vast majority of extensions which can be safely
ignored. This promotes interoperability by eliminating the need for implementers
to prohibit the presence of extensions. For further information, see the [definition
of modifier extensions](extensibility.html#modifierExtension)."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
resource that contains them"/>
<isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="DocumentReference.identifier"> <path value="DocumentReference.identifier"/> <short value="Business identifiers for the document"/> <definition value="Business identifiers assigned to this document reference by the performer and/or
other systems. These identifiers remain constant as the resource is updated and
propagates from server to server."/>
<comment value="The structure and format of this identifier would be consistent with the specification
corresponding to the format of the document. (e.g. for a DICOM standard document,
a 64-character numeric UID; for an HL7 CDA format, the CDA Document Id root and
extension)."/>
<requirements value="Document identifiers usually assigned by the source of the document, or other business
identifiers such as XDS DocumentEntry.uniqueId and DocumentEntry.entryUUID. These
identifiers are specific to this instance of the document."/>
<min value="0"/> <max value="*"/> <base> <path value="DocumentReference.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() > 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="v2"/> <map value="TXA-12"/> </mapping> <mapping> <identity value="rim"/> <map value=".id / .setId"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.identifier"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.entryUUID, DocumentEntry.uniqueId"/> </mapping> <mapping> <identity value="cda"/> <map value="ClinicalDocument/id"/> </mapping> </element> <element id="DocumentReference.version"> <path value="DocumentReference.version"/> <short value="An explicitly assigned identifier of a variation of the content in the DocumentReference"/> <definition value="An explicitly assigned identifier of a variation of the content in the DocumentReference."/> <comment value="While each resource, including the DocumentReference itself, has its own version
identifier, this is a formal identifier for the logical version of the DocumentReference
as a whole. It would remain constant if the resources were moved to a new server,
and all got new individual resource versions, for example."/>
<min value="0"/> <max value="1"/> <base> <path value="DocumentReference.version"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > 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="fhircomposition"/> <map value="Composition.version"/> </mapping> </element> <element id="DocumentReference.basedOn"> <path value="DocumentReference.basedOn"/> <short value="Procedure that caused this media to be created"/> <definition value="A procedure that is fulfilled in whole or in part by the creation of this media."/> <requirements value="Allows tracing of authorization for the event and tracking whether proposals/recommendations
were acted upon."/>
<alias value="fulfills"/> <min value="0"/> <max value="*"/> <base> <path value="DocumentReference.basedOn"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Appointment"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/AppointmentResponse"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Claim"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CommunicationRequest"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Contract"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CoverageEligibilityRequest"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceRequest"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/EnrollmentRequest"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/NutritionOrder"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RequestOrchestration"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/VisionPrescription"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Event.basedOn"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=FLFS].target"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.referenceIdList"/> </mapping> </element> <element id="DocumentReference.status"> <path value="DocumentReference.status"/> <short value="current | superseded | entered-in-error"/> <definition value="The current state of the document reference."/> <comment value="This is the status of the DocumentReference object, which might be independent
from the docStatus element.
This element is labeled as a modifier because the status contains the codes that
mark the document or reference as not currently valid."/>
<min value="1"/> <max value="1"/> <base> <path value="DocumentReference.status"/> <min value="1"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="This element is labelled as a modifier because it is a status element that contains
status entered-in-error which means that the resource should not be treated as
valid"/>
<isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentReferenceStatus"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="required"/> <description value="The status of the document reference."/> <valueSet value="http://hl7.org/fhir/ValueSet/document-reference-status|6.0.0-ballot4"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.status"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.status"/> </mapping> <mapping> <identity value="v2"/> <map value="TXA-19"/> </mapping> <mapping> <identity value="rim"/> <map value="interim: .completionCode="IN" & ./statusCode[isNormalDatatype()]="active&q
uot;; final: .completionCode="AU" && ./statusCode[isNormalDatatype()]=&quo
t;complete" and not(./inboundRelationship[typeCode="SUBJ" and isNormalActRelati
onship()]/source[subsumesCode("ActClass#CACT") and moodCode="EVN"
and domainMember("ReviseDocument", code) and isNormalAct()]); amended:
.completionCode="AU" && ./statusCode[isNormalDatatype()]="complete&qu
ot; and ./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[
subsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("Re
viseDocument", code) and isNormalAct() and statusCode="completed"];
withdrawn : .completionCode=NI && ./statusCode[isNormalDatatype()]="obsolete&q
uot;"/>
</mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.availabilityStatus"/> </mapping> </element> <element id="DocumentReference.docStatus"> <path value="DocumentReference.docStatus"/> <short value="registered | partial | preliminary | final | amended | corrected | appended | cancelled
| entered-in-error | deprecated | unknown"/>
<definition value="The status of the underlying document."/> <comment value="The document that is pointed to might be in various lifecycle states."/> <min value="0"/> <max value="1"/> <base> <path value="DocumentReference.docStatus"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="This element is labelled as a modifier because it is a status element that contains
status entered-in-error which means that the resource should not be treated as
valid"/>
<isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ReferredDocumentStatus"/> </extension> <strength value="required"/> <description value="Status of the underlying document."/> <valueSet value="http://hl7.org/fhir/ValueSet/composition-status|6.0.0-ballot4"/> </binding> <mapping> <identity value="w5"/> <map value="FiveWs.status"/> </mapping> <mapping> <identity value="v2"/> <map value="TXA-17"/> </mapping> <mapping> <identity value="rim"/> <map value=".statusCode"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.status"/> </mapping> </element> <element id="DocumentReference.modality"> <path value="DocumentReference.modality"/> <short value="Imaging modality used"/> <definition value="Imaging modality used. This may include both acquisition and non-acquisition modalities."/> <min value="0"/> <max value="*"/> <base> <path value="DocumentReference.modality"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ImagingModality"/> </extension> <strength value="extensible"/> <description value="Type of acquired data in the instance."/> <valueSet value="http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_33.html"/> </binding> <mapping> <identity value="w5"/> <map value="FiveWs.class"/> </mapping> </element> <element id="DocumentReference.type"> <path value="DocumentReference.type"/> <short value="Kind of document (LOINC if possible)"/> <definition value="Specifies the particular kind of document referenced (e.g. History and Physical,
Discharge Summary, Progress Note). This usually equates to the purpose of making
the document referenced."/>
<comment value="Key metadata element describing the document that describes he exact type of document.
Helps humans to assess whether the document is of interest when viewing a list
of documents."/>
<min value="0"/> <max value="1"/> <base> <path value="DocumentReference.type"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentType"/> </extension> <strength value="preferred"/> <description value="Precise type of clinical document."/> <valueSet value="http://hl7.org/fhir/ValueSet/doc-typecodes"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.code"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.what[x]"/> </mapping> <mapping> <identity value="v2"/> <map value="TXA-2"/> </mapping> <mapping> <identity value="rim"/> <map value="./code"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.type"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.typeCode"/> </mapping> <mapping> <identity value="cda"/> <map value="ClinicalDocument/code/@code
The typeCode should be mapped from the ClinicalDocument/code element to a set of
document type codes configured in the affinity domain. One suggested coding system
to use for typeCode is LOINC, in which case the mapping step can be omitted."/>
</mapping> </element> <element id="DocumentReference.category"> <path value="DocumentReference.category"/> <short value="Categorization of document"/> <definition value="A categorization for the type of document referenced - helps for indexing and searching.
This may be implied by or derived from the code specified in the DocumentReference.type."/>
<comment value="Key metadata element describing the the category or classification of the document.
This is a broader perspective that groups similar documents based on how they would
be used. This is a primary key used in searching."/>
<alias value="class"/> <alias value="classCode"/> <min value="0"/> <max value="*"/> <base> <path value="DocumentReference.category"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ReferencedItemCategory"/> </extension> <strength value="example"/> <description value="High-level kind of document at a macro level."/> <valueSet value="http://hl7.org/fhir/ValueSet/referenced-item-category"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.category"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.what[x]"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="
EVN"].code"/>
</mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.category"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.classCode"/> </mapping> <mapping> <identity value="cda"/> <map value="Derived from a mapping of /ClinicalDocument/code/@code to an Affinity Domain specified
coded value to use and coding system. Affinity Domains are encouraged to use the
appropriate value for Type of Service, based on the LOINC Type of Service (see
Page 53 of the LOINC User's Manual). Must be consistent with /ClinicalDocument/code/@code"/>
</mapping> </element> <element id="DocumentReference.subject"> <path value="DocumentReference.subject"/> <short value="Who/what is the subject of the document"/> <definition value="Who or what the document is about. The document can be about a person, (patient
or healthcare practitioner), a device (e.g. a machine) or even a group of subjects
(such as a document about a herd of farm animals, or a set of patients that share
a common exposure)."/>
<min value="0"/> <max value="1"/> <base> <path value="DocumentReference.subject"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > 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"/> </mapping> <mapping> <identity value="v2"/> <map value="PID-3 (No standard way to define a Practitioner or Group subject in HL7 V2 MDM
message)"/>
</mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode="SBJ"].role[typeCode="PAT"]"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.subject"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.patientId"/> </mapping> <mapping> <identity value="cda"/> <map value="ClinicalDocument/recordTarget/"/> </mapping> </element> <element id="DocumentReference.context"> <path value="DocumentReference.context"/> <short value="Encounter the document reference is part of"/> <definition value="The Encounter during which this document reference was created or to which the
creation of this record is tightly associated."/>
<comment value="This will typically be the encounter the document reference was created during,
but some document references may be initiated prior to or after the official completion
of an encounter but still be tied to the context of the encounter (e.g. pre-admission
lab tests)."/>
<requirements value="Links the document reference to the Encounter context. May also affect access
control."/>
<min value="0"/> <max value="*"/> <base> <path value="DocumentReference.context"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Appointment"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"/> </type> <condition value="docRef-1"/> <condition value="docRef-2"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > 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"/> <map value="unique(highest(./outboundRelationship[typeCode="SUBJ" and isNormalActRelationship()
], priorityNumber)/target[moodCode="EVN" and classCode=("ENC",
"PCPR") and isNormalAct])"/>
</mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.encounter"/> </mapping> </element> <element id="DocumentReference.event"> <path value="DocumentReference.event"/> <short value="Main clinical acts documented"/> <definition value="This list of codes represents the main clinical acts, such as a colonoscopy or
an appendectomy, being documented. In some cases, the event is inherent in the
type Code, such as a "History and Physical Report" in which the procedure
being documented is necessarily a "History and Physical" act."/>
<comment value="An event can further specialize the act inherent in the type, such as where it
is simply "Procedure Report" and the procedure was a "colonoscopy".
If one or more event codes are included, they shall not conflict with the values
inherent in the class or type elements as such a conflict would create an ambiguous
situation."/>
<min value="0"/> <max value="*"/> <base> <path value="DocumentReference.event"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableReference"/> <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() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentEventType"/> </extension> <strength value="example"/> <description value="This list of codes represents the main clinical acts being documented."/> <valueSet value="http://terminology.hl7.org/ValueSet/v3-ActCode"/> </binding> <mapping> <identity value="rim"/> <map value=".code"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.event.detail"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.eventCodeList"/> </mapping> </element> <element id="DocumentReference.related"> <path value="DocumentReference.related"/> <short value="Related identifiers or resources associated with the document reference"/> <definition value="Any other resource this document reference was created or to which the creation
of this record is tightly associated."/>
<comment value="Use only for references not covered by other elements."/> <min value="0"/> <max value="*"/> <base> <path value="DocumentReference.related"/> <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() > 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="PERT" and isNormalActRelationship()]
/ target[isNormalAct]"/>
</mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.event.detail"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.referenceIdList"/> </mapping> </element> <element id="DocumentReference.bodyStructure"> <path value="DocumentReference.bodyStructure"/> <short value="Body structure included"/> <definition value="The anatomic structures included in the document."/> <min value="0"/> <max value="*"/> <base> <path value="DocumentReference.bodyStructure"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableReference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/BodyStructure"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition"> <valueMarkdown value="Codes describing anatomical body structures. May include laterality."/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BodyStructure"/> </extension> <strength value="example"/> <description value="SNOMED CT Body Structures"/> <valueSet value="http://hl7.org/fhir/ValueSet/body-site"/> </binding> <mapping> <identity value="rim"/> <map value=".targetSiteCode"/> </mapping> </element> <element id="DocumentReference.facilityType"> <path value="DocumentReference.facilityType"/> <short value="Kind of facility where patient was seen"/> <definition value="The kind of facility where the patient was seen."/> <min value="0"/> <max value="1"/> <base> <path value="DocumentReference.facilityType"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <condition value="docRef-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentC80FacilityType"/> </extension> <strength value="example"/> <description value="XDS Facility Type."/> <valueSet value="http://hl7.org/fhir/ValueSet/c80-facilitycodes"/> </binding> <mapping> <identity value="rim"/> <map value=".participation[typeCode="LOC"].role[classCode="DSDLOC"].code"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="usually from a mapping to a local ValueSet"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.healthcareFacilityTypeCode"/> </mapping> <mapping> <identity value="cda"/> <map value="usually a mapping to a local ValueSet. Must be consistent with /clinicalDocument/code"/> </mapping> </element> <element id="DocumentReference.practiceSetting"> <path value="DocumentReference.practiceSetting"/> <short value="Additional details about where the content was created (e.g. clinical specialty)"/> <definition value="This property may convey specifics about the practice setting where the content
was created, often reflecting the clinical specialty."/>
<comment value="This element should be based on a coarse classification system for the class of
specialty practice. Recommend the use of the classification system for Practice
Setting, such as that described by the Subject Matter Domain in LOINC."/>
<requirements value="This is an important piece of metadata that providers often rely upon to quickly
sort and/or filter out to find specific content."/>
<min value="0"/> <max value="1"/> <base> <path value="DocumentReference.practiceSetting"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <condition value="docRef-2"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentC80PracticeSetting"/> </extension> <strength value="example"/> <description value="Additional details about where the content was created (e.g. clinical specialty)."/> <valueSet value="http://hl7.org/fhir/ValueSet/c80-practice-codes"/> </binding> <mapping> <identity value="rim"/> <map value=".participation[typeCode="LOC"].role[classCode="DSDLOC"].code"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="usually from a mapping to a local ValueSet"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.practiceSettingCode"/> </mapping> <mapping> <identity value="cda"/> <map value="usually from a mapping to a local ValueSet"/> </mapping> </element> <element id="DocumentReference.period"> <path value="DocumentReference.period"/> <short value="Time of service that is being documented"/> <definition value="The time period over which the service that is described by the document was provided."/> <min value="0"/> <max value="1"/> <base> <path value="DocumentReference.period"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Period"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > 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"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.event.period"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.serviceStartTime, DocumentEntry.serviceStopTime"/> </mapping> <mapping> <identity value="cda"/> <map value="ClinicalDocument/documentationOf/
serviceEvent/effectiveTime/low/
@value --> ClinicalDocument/documentationOf/
serviceEvent/effectiveTime/high/
@value"/>
</mapping> </element> <element id="DocumentReference.date"> <path value="DocumentReference.date"/> <short value="When this document reference was created"/> <definition value="When the document reference was created."/> <comment value="Referencing/indexing time is used for tracking, organizing versions and searching.
Provide the most precise timestamp available."/>
<alias value="indexed"/> <min value="0"/> <max value="1"/> <base> <path value="DocumentReference.date"/> <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() > 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.recorded"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.recorded"/> </mapping> <mapping> <identity value="rim"/> <map value=".availabilityTime[type="TS"]"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.date"/> </mapping> </element> <element id="DocumentReference.author"> <path value="DocumentReference.author"/> <short value="Who and/or what authored the document"/> <definition value="Identifies who is responsible for adding the information to the document."/> <comment value="Not necessarily who did the actual data entry (i.e. typist) or who was the source
(informant). Using Group is only allowed in the circumstance where the group represents
a family or a household, and should not represent groups of Practitioners. "/>
<min value="0"/> <max value="*"/> <base> <path value="DocumentReference.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/Organization"/> <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/CareTeam"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> </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() > 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.actor"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.author"/> </mapping> <mapping> <identity value="v2"/> <map value="TXA-9 (No standard way to indicate a Device in HL7 V2 MDM message)"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.author"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.author"/> </mapping> <mapping> <identity value="cda"/> <map value="ClinicalDocument/author"/> </mapping> </element> <element id="DocumentReference.attester"> <path value="DocumentReference.attester"/> <short value="Attests to accuracy of the document"/> <definition value="A participant who has authenticated the accuracy of the document."/> <comment value="Only list each attester once."/> <requirements value="Identifies responsibility for the accuracy of the document content."/> <min value="0"/> <max value="*"/> <base> <path value="DocumentReference.attester"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children or both"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Event.performer"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode="AUTHEN"].role[classCode="ASSIGNED"]"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.attester"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.legalAuthenticator"/> </mapping> <mapping> <identity value="cda"/> <map value=".authenticator/.legalAuthenticator"/> </mapping> </element> <element id="DocumentReference.attester.id"> <path value="DocumentReference.attester.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may
be any string value that does not contain spaces."/>
<min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base>
<type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="DocumentReference.attester.extension"> <path value="DocumentReference.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 managable, there is a strict
set of governance applied to the definition and use of extensions. Though any implementer
can define an extension, there is a set of requirements that SHALL be met as part
of the definition of the extension."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="DocumentReference.attester.modifierExtension"> <path value="DocumentReference.attester.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="May be used to represent additional information that is not part of the basic definition
of the element and that modifies the understanding of the element in which it is
contained and/or the understanding of the containing element's descendants. Usually
modifier elements provide negation or qualification. To make the use of extensions
safe and managable, there is a strict set of governance applied to the definition
and use of extensions. Though any implementer can define an extension, there is
a set of requirements that SHALL be met as part of the definition of the extension.
Applications processing a resource are required to check for modifier extensions.
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() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
element that contains them"/>
<isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="DocumentReference.attester.mode"> <path value="DocumentReference.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="DocumentReference.attester.mode"/> <min value="1"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentAttestationMode"/> </extension> <strength value="preferred"/> <description value="The way in which a person authenticated a document."/> <valueSet value="http://hl7.org/fhir/ValueSet/composition-attestation-mode"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.performer.function"/> </mapping> <mapping> <identity value="rim"/> <map value="unique(./modeCode)"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.attester.mode"/> </mapping> <mapping> <identity value="cda"/> <map value="implied by .authenticator/.legalAuthenticator"/> </mapping> </element> <element id="DocumentReference.attester.time"> <path value="DocumentReference.attester.time"/> <short value="When the document was attested"/> <definition value="When the document was attested by the party."/> <requirements value="Identifies when the information in the document was deemed accurate. (Things may
have changed since then.)."/>
<min value="0"/> <max value="1"/> <base> <path value="DocumentReference.attester.time"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > 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="TS" and isNormalDatatype()]"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.attester.time"/> </mapping> <mapping> <identity value="cda"/> <map value=".authenticator.time"/> </mapping> </element> <element id="DocumentReference.attester.party"> <path value="DocumentReference.attester.party"/> <short value="Who attested the document"/> <definition value="Who attested the document in the specified way."/> <comment value="Using Group is only allowed in the circumstance where the group represents a family
or a household, and should not represent groups of Practitioners. "/>
<requirements value="Identifies who has taken on the responsibility for accuracy of the document content."/> <min value="0"/> <max value="1"/> <base> <path value="DocumentReference.attester.party"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> </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() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Event.performer.actor"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.witness"/> </mapping> <mapping> <identity value="v2"/> <map value="TXA-10"/> </mapping> <mapping> <identity value="rim"/> <map value="./role[classCode="ASSIGNED" and isNormalRole]/player[determinerCode="INST"
; and classCode=("DEV", "PSN") and isNormalEntity()] or ./role[classCode=&
quot;ASSIGNED" and isNormalRole and not(player)]/scoper[determinerCode="INST"
and classCode="ORG" and isNormalEntity()]"/>
</mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.attester.party"/> </mapping> <mapping> <identity value="cda"/> <map value=".authenticator.assignedEnttty"/> </mapping> </element> <element id="DocumentReference.custodian"> <path value="DocumentReference.custodian"/> <short value="Organization which maintains the document"/> <definition value="Identifies the organization or group who is responsible for ongoing maintenance
of and access to the document."/>
<comment value="Identifies the logical organization (software system, vendor, or department) to
go to find the current version, where to report issues, etc. This is different
from the physical location (URL, disk drive, or server) of the document, which
is the technical location of the document, which host may be delegated to the management
of some other organization."/>
<min value="0"/> <max value="1"/> <base> <path value="DocumentReference.custodian"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > 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="RCV"].role[classCode="CUST"].scoper[classCode=&q
uot;ORG" and determinerCode="INST"]"/>
</mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.custodian"/> </mapping> </element> <element id="DocumentReference.relatesTo"> <path value="DocumentReference.relatesTo"/> <short value="Relationships to other documents"/> <definition value="Relationships that this document has with other document references that already
exist."/>
<comment value="This element is labeled as a modifier because documents that append to other documents
are incomplete on their own."/>
<min value="0"/> <max value="*"/> <base> <path value="DocumentReference.relatesTo"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children or both"/> <expression value="hasValue() or (children().count() > 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"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.relatesTo"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry Associations"/> </mapping> </element> <element id="DocumentReference.relatesTo.id"> <path value="DocumentReference.relatesTo.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may
be any string value that does not contain spaces."/>
<min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base>
<type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="DocumentReference.relatesTo.extension"> <path value="DocumentReference.relatesTo.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 managable, there is a strict
set of governance applied to the definition and use of extensions. Though any implementer
can define an extension, there is a set of requirements that SHALL be met as part
of the definition of the extension."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="DocumentReference.relatesTo.modifierExtension"> <path value="DocumentReference.relatesTo.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="May be used to represent additional information that is not part of the basic definition
of the element and that modifies the understanding of the element in which it is
contained and/or the understanding of the containing element's descendants. Usually
modifier elements provide negation or qualification. To make the use of extensions
safe and managable, there is a strict set of governance applied to the definition
and use of extensions. Though any implementer can define an extension, there is
a set of requirements that SHALL be met as part of the definition of the extension.
Applications processing a resource are required to check for modifier extensions.
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() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
element that contains them"/>
<isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="DocumentReference.relatesTo.code"> <path value="DocumentReference.relatesTo.code"/> <short value="The relationship type with another document"/> <definition value="The type of relationship that this document has with anther document."/> <comment value="If this document appends another document, then the document cannot be fully understood
without also accessing the referenced document."/>
<min value="1"/> <max value="1"/> <base> <path value="DocumentReference.relatesTo.code"/> <min value="1"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentRelationshipType"/> </extension> <strength value="extensible"/> <description value="The type of relationship between the documents."/> <valueSet value="http://hl7.org/fhir/ValueSet/document-relationship-type"/> </binding> <mapping> <identity value="rim"/> <map value=".outboundRelationship.typeCode"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.relatesTo.type"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry Associations type"/> </mapping> <mapping> <identity value="cda"/> <map value="ClinicalDocument/relatedDocument/typeCode"/> </mapping> </element> <element id="DocumentReference.relatesTo.target"> <path value="DocumentReference.relatesTo.target"/> <short value="Target of the relationship"/> <definition value="The target document of this relationship."/> <min value="1"/> <max value="1"/> <base> <path value="DocumentReference.relatesTo.target"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > 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=".target[classCode="DOC", moodCode="EVN"].id"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.relatesTo.targetReference"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry Associations reference"/> </mapping> <mapping> <identity value="cda"/> <map value="ClinicalDocument/relatedDocument/parentDocument"/> </mapping> </element> <element id="DocumentReference.description"> <path value="DocumentReference.description"/> <short value="Human-readable description"/> <definition value="Human-readable description of the source document."/> <comment value="What the document is about, a terse summary of the document."/> <requirements value="Helps humans to assess whether the document is of interest."/> <min value="0"/> <max value="1"/> <base> <path value="DocumentReference.description"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="TXA-25"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode="SUBJ"].target.text"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.comments"/> </mapping> </element> <element id="DocumentReference.securityLabel"> <path value="DocumentReference.securityLabel"/> <short value="Document security-tags"/> <definition value="A set of Security-Tag codes specifying the level of privacy/security of the Document
found at DocumentReference.content.attachment.url. Note that DocumentReference.meta.security
contains the security labels of the data elements in DocumentReference, while DocumentReferen
ce.securityLabel contains the security labels for the document the reference refers
to. The distinction recognizes that the document may contain sensitive information,
while the DocumentReference is metadata about the document and thus might not be
as sensitive as the document. For example: a psychotherapy episode may contain
highly sensitive information, while the metadata may simply indicate that some
episode happened."/>
<comment value="The confidentiality codes can carry multiple vocabulary items. HL7 has developed
an understanding of security and privacy tags that might be desirable in a Document
Sharing environment, called HL7 Healthcare Privacy and Security Classification
System (HCS). The following specification is recommended but not mandated, as the
vocabulary bindings are an administrative domain responsibility. The use of this
method is up to the policy domain such as the XDS Affinity Domain or other Trust
Domain where all parties including sender and recipients are trusted to appropriately
tag and enforce.
In the HL7 Healthcare Privacy and Security Classification (HCS) there are code
systems specific to Confidentiality, Sensitivity, Integrity, and Handling Caveats.
Some values would come from a local vocabulary as they are related to workflow
roles and special projects."/>
<requirements value="Use of the Health Care Privacy/Security Classification (HCS) system of security-tag
use is recommended."/>
<min value="0"/> <max value="*"/> <base> <path value="DocumentReference.securityLabel"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="SecurityLabels"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="example"/> <description value="Example Security Labels from the Healthcare Privacy and Security Classification
System."/>
<valueSet value="http://hl7.org/fhir/ValueSet/security-label-example"/> </binding> <mapping> <identity value="v2"/> <map value="TXA-18"/> </mapping> <mapping> <identity value="rim"/> <map value=".confidentialityCode"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Bundle.meta.security"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.confidentialityCode"/> </mapping> <mapping> <identity value="cda"/> <map value="ClinicalDocument/confidentialityCode/@code"/> </mapping> </element> <element id="DocumentReference.content"> <path value="DocumentReference.content"/> <short value="Document referenced"/> <definition value="The document and format referenced. If there are multiple content element repetitions,
these must all represent the same document in different format, or attachment metadata."/>
<comment value="content element shall not contain different versions of the same content. For version
handling use multiple DocumentReference with .relatesTo."/>
<requirements value="Note that .relatesTo may also include references to other DocumentReference with
a transforms relationship to represent the same document in multiple formats."/>
<min value="1"/> <max value="*"/> <base> <path value="DocumentReference.content"/> <min value="1"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children or both"/> <expression value="hasValue() or (children().count() > 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="document.text"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Bundle(Composition+*)"/> </mapping> </element> <element id="DocumentReference.content.id"> <path value="DocumentReference.content.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may
be any string value that does not contain spaces."/>
<min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base>
<type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="DocumentReference.content.extension"> <path value="DocumentReference.content.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 managable, there is a strict
set of governance applied to the definition and use of extensions. Though any implementer
can define an extension, there is a set of requirements that SHALL be met as part
of the definition of the extension."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="DocumentReference.content.modifierExtension"> <path value="DocumentReference.content.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="May be used to represent additional information that is not part of the basic definition
of the element and that modifies the understanding of the element in which it is
contained and/or the understanding of the containing element's descendants. Usually
modifier elements provide negation or qualification. To make the use of extensions
safe and managable, there is a strict set of governance applied to the definition
and use of extensions. Though any implementer can define an extension, there is
a set of requirements that SHALL be met as part of the definition of the extension.
Applications processing a resource are required to check for modifier extensions.
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() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
element that contains them"/>
<isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="DocumentReference.content.attachment"> <path value="DocumentReference.content.attachment"/> <short value="Where to access the document"/> <definition value="The document or URL of the document along with critical metadata to prove content
has integrity."/>
<min value="1"/> <max value="1"/> <base> <path value="DocumentReference.content.attachment"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Attachment"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="TXA-3 for mime type"/> </mapping> <mapping> <identity value="rim"/> <map value="document.text"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.language,
Composition.title,
Composition.date"/>
</mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.mimeType, DocumentEntry.languageCode, DocumentEntry.repositoryUniqueId,
DocumentEntry.URI, DocumentEntry.size, DocumentEntry.hash, DocumentEntry.title,
DocumentEntry.creationTime"/>
</mapping> <mapping> <identity value="cda"/> <map value="ClinicalDocument/languageCode, ClinicalDocument/title, ClinicalDocument/date"/> </mapping> </element> <element id="DocumentReference.content.profile"> <path value="DocumentReference.content.profile"/> <short value="Content profile rules for the document"/> <definition value="An identifier of the document constraints, encoding, structure, and template that
the document conforms to beyond the base format indicated in the mimeType."/>
<comment value="Note that IHE often issues URNs for formatCode codes, not all documents can be
identified by a URI.
For FHIR content, .profile should indicate the structureDefinition profile canonical
URI(s) that the content complies with."/>
<alias value="format"/> <alias value="formatCode"/> <min value="0"/> <max value="*"/> <base> <path value="DocumentReference.content.profile"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children or both"/> <expression value="hasValue() or (children().count() > 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="document.text"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.meta.profile"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.formatCode"/> </mapping> <mapping> <identity value="cda"/> <map value="derived from the IHE Profile or Implementation Guide templateID"/> </mapping> </element> <element id="DocumentReference.content.profile.id"> <path value="DocumentReference.content.profile.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may
be any string value that does not contain spaces."/>
<min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base>
<type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="DocumentReference.content.profile.extension"> <path value="DocumentReference.content.profile.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 managable, there is a strict
set of governance applied to the definition and use of extensions. Though any implementer
can define an extension, there is a set of requirements that SHALL be met as part
of the definition of the extension."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="DocumentReference.content.profile.modifierExtension"> <path value="DocumentReference.content.profile.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="May be used to represent additional information that is not part of the basic definition
of the element and that modifies the understanding of the element in which it is
contained and/or the understanding of the containing element's descendants. Usually
modifier elements provide negation or qualification. To make the use of extensions
safe and managable, there is a strict set of governance applied to the definition
and use of extensions. Though any implementer can define an extension, there is
a set of requirements that SHALL be met as part of the definition of the extension.
Applications processing a resource are required to check for modifier extensions.
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() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
element that contains them"/>
<isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="DocumentReference.content.profile.value[x]"> <path value="DocumentReference.content.profile.value[x]"/> <short value="Code|uri|canonical"/> <definition value="Code|uri|canonical."/> <min value="1"/> <max value="1"/> <base> <path value="DocumentReference.content.profile.value[x]"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <type> <code value="uri"/> </type> <type> <code value="canonical"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentFormat"/> </extension> <strength value="preferred"/> <description value="Document Format Codes."/> <valueSet value="http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes"/> </binding> <mapping> <identity value="rim"/> <map value="document.text"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.meta.profile"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.formatCode"/> </mapping> <mapping> <identity value="cda"/> <map value="derived from the IHE Profile or Implementation Guide templateID"/> </mapping> </element> </snapshot> <differential> <element id="DocumentReference"> <path value="DocumentReference"/> <short value="A reference to a document"/> <definition value="A reference to a document of any kind for any purpose. While the term “document”
implies a more narrow focus, for this resource this "document" encompasses
*any* serialized object with a mime-type, it includes formal patient-centric documents
(CDA), clinical notes, scanned paper, non-patient specific documents like policy
text, as well as a photo, video, or audio recording acquired or used in healthcare.
The DocumentReference resource provides metadata about the document so that the
document can be discovered and managed. The actual content may be inline base64
encoded data or provided by direct reference."/>
<comment value="Usually, this is used for documents other than those defined by FHIR."/> <min value="0"/> <max value="*"/> <constraint> <key value="docRef-1"/> <severity value="warning"/> <human value="facilityType SHALL only be present if context is not an encounter"/> <expression value="facilityType.empty() or context.where(resolve() is Encounter).empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/> </constraint> <constraint> <key value="docRef-2"/> <severity value="warning"/> <human value="practiceSetting SHALL only be present if context is not present"/> <expression value="practiceSetting.empty() or context.where(resolve() is Encounter).empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <mapping> <identity value="workflow"/> <map value="Event"/> </mapping> <mapping> <identity value="w5"/> <map value="infrastructure.documents"/> </mapping> <mapping> <identity value="rim"/> <map value="Document[classCode="DOC" and moodCode="EVN"]"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="when describing a Composition"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry"/> </mapping> <mapping> <identity value="cda"/> <map value="when describing a CDA"/> </mapping> </element> <element id="DocumentReference.identifier"> <path value="DocumentReference.identifier"/> <short value="Business identifiers for the document"/> <definition value="Business identifiers assigned to this document reference by the performer and/or
other systems. These identifiers remain constant as the resource is updated and
propagates from server to server."/>
<comment value="The structure and format of this identifier would be consistent with the specification
corresponding to the format of the document. (e.g. for a DICOM standard document,
a 64-character numeric UID; for an HL7 CDA format, the CDA Document Id root and
extension)."/>
<requirements value="Document identifiers usually assigned by the source of the document, or other business
identifiers such as XDS DocumentEntry.uniqueId and DocumentEntry.entryUUID. These
identifiers are specific to this instance of the document."/>
<min value="0"/> <max value="*"/> <type> <code value="Identifier"/> </type> <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="v2"/> <map value="TXA-12"/> </mapping> <mapping> <identity value="rim"/> <map value=".id / .setId"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.identifier"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.entryUUID, DocumentEntry.uniqueId"/> </mapping> <mapping> <identity value="cda"/> <map value="ClinicalDocument/id"/> </mapping> </element> <element id="DocumentReference.version"> <path value="DocumentReference.version"/> <short value="An explicitly assigned identifier of a variation of the content in the DocumentReference"/> <definition value="An explicitly assigned identifier of a variation of the content in the DocumentReference."/> <comment value="While each resource, including the DocumentReference itself, has its own version
identifier, this is a formal identifier for the logical version of the DocumentReference
as a whole. It would remain constant if the resources were moved to a new server,
and all got new individual resource versions, for example."/>
<min value="0"/> <max value="1"/> <type> <code value="string"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="w5"/> <map value="FiveWs.version"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.version"/> </mapping> </element> <element id="DocumentReference.basedOn"> <path value="DocumentReference.basedOn"/> <short value="Procedure that caused this media to be created"/> <definition value="A procedure that is fulfilled in whole or in part by the creation of this media."/> <requirements value="Allows tracing of authorization for the event and tracking whether proposals/recommendations
were acted upon."/>
<alias value="fulfills"/> <min value="0"/> <max value="*"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Appointment"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/AppointmentResponse"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Claim"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CommunicationRequest"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Contract"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CoverageEligibilityRequest"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceRequest"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/EnrollmentRequest"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/NutritionOrder"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RequestOrchestration"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/VisionPrescription"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Event.basedOn"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=FLFS].target"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.referenceIdList"/> </mapping> </element> <element id="DocumentReference.status"> <path value="DocumentReference.status"/> <short value="current | superseded | entered-in-error"/> <definition value="The current state of the document reference."/> <comment value="This is the status of the DocumentReference object, which might be independent
from the docStatus element.
This element is labeled as a modifier because the status contains the codes that
mark the document or reference as not currently valid."/>
<min value="1"/> <max value="1"/> <type> <code value="code"/> </type> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="This element is labelled as a modifier because it is a status element that contains
status entered-in-error which means that the resource should not be treated as
valid"/>
<isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentReferenceStatus"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="required"/> <description value="The status of the document reference."/> <valueSet value="http://hl7.org/fhir/ValueSet/document-reference-status|6.0.0-ballot4"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.status"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.status"/> </mapping> <mapping> <identity value="v2"/> <map value="TXA-19"/> </mapping> <mapping> <identity value="rim"/> <map value="interim: .completionCode="IN" & ./statusCode[isNormalDatatype()]="active&q
uot;; final: .completionCode="AU" && ./statusCode[isNormalDatatype()]=&quo
t;complete" and not(./inboundRelationship[typeCode="SUBJ" and isNormalActRelati
onship()]/source[subsumesCode("ActClass#CACT") and moodCode="EVN"
and domainMember("ReviseDocument", code) and isNormalAct()]); amended:
.completionCode="AU" && ./statusCode[isNormalDatatype()]="complete&qu
ot; and ./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[
subsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("Re
viseDocument", code) and isNormalAct() and statusCode="completed"];
withdrawn : .completionCode=NI && ./statusCode[isNormalDatatype()]="obsolete&q
uot;"/>
</mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.availabilityStatus"/> </mapping> </element> <element id="DocumentReference.docStatus"> <path value="DocumentReference.docStatus"/> <short value="registered | partial | preliminary | final | amended | corrected | appended | cancelled
| entered-in-error | deprecated | unknown"/>
<definition value="The status of the underlying document."/> <comment value="The document that is pointed to might be in various lifecycle states."/> <min value="0"/> <max value="1"/> <type> <code value="code"/> </type> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="This element is labelled as a modifier because it is a status element that contains
status entered-in-error which means that the resource should not be treated as
valid"/>
<isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ReferredDocumentStatus"/> </extension> <strength value="required"/> <description value="Status of the underlying document."/> <valueSet value="http://hl7.org/fhir/ValueSet/composition-status|6.0.0-ballot4"/> </binding> <mapping> <identity value="w5"/> <map value="FiveWs.status"/> </mapping> <mapping> <identity value="v2"/> <map value="TXA-17"/> </mapping> <mapping> <identity value="rim"/> <map value=".statusCode"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.status"/> </mapping> </element> <element id="DocumentReference.modality"> <path value="DocumentReference.modality"/> <short value="Imaging modality used"/> <definition value="Imaging modality used. This may include both acquisition and non-acquisition modalities."/> <min value="0"/> <max value="*"/> <type> <code value="CodeableConcept"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ImagingModality"/> </extension> <strength value="extensible"/> <description value="Type of acquired data in the instance."/> <valueSet value="http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_33.html"/> </binding> <mapping> <identity value="w5"/> <map value="FiveWs.class"/> </mapping> </element> <element id="DocumentReference.type"> <path value="DocumentReference.type"/> <short value="Kind of document (LOINC if possible)"/> <definition value="Specifies the particular kind of document referenced (e.g. History and Physical,
Discharge Summary, Progress Note). This usually equates to the purpose of making
the document referenced."/>
<comment value="Key metadata element describing the document that describes he exact type of document.
Helps humans to assess whether the document is of interest when viewing a list
of documents."/>
<min value="0"/> <max value="1"/> <type> <code value="CodeableConcept"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentType"/> </extension> <strength value="preferred"/> <description value="Precise type of clinical document."/> <valueSet value="http://hl7.org/fhir/ValueSet/doc-typecodes"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.code"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.what[x]"/> </mapping> <mapping> <identity value="v2"/> <map value="TXA-2"/> </mapping> <mapping> <identity value="rim"/> <map value="./code"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.type"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.typeCode"/> </mapping> <mapping> <identity value="cda"/> <map value="ClinicalDocument/code/@code
The typeCode should be mapped from the ClinicalDocument/code element to a set of
document type codes configured in the affinity domain. One suggested coding system
to use for typeCode is LOINC, in which case the mapping step can be omitted."/>
</mapping> </element> <element id="DocumentReference.category"> <path value="DocumentReference.category"/> <short value="Categorization of document"/> <definition value="A categorization for the type of document referenced - helps for indexing and searching.
This may be implied by or derived from the code specified in the DocumentReference.type."/>
<comment value="Key metadata element describing the the category or classification of the document.
This is a broader perspective that groups similar documents based on how they would
be used. This is a primary key used in searching."/>
<alias value="class"/> <alias value="classCode"/> <min value="0"/> <max value="*"/> <type> <code value="CodeableConcept"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ReferencedItemCategory"/> </extension> <strength value="example"/> <description value="High-level kind of document at a macro level."/> <valueSet value="http://hl7.org/fhir/ValueSet/referenced-item-category"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.category"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.what[x]"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="
EVN"].code"/>
</mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.category"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.classCode"/> </mapping> <mapping> <identity value="cda"/> <map value="Derived from a mapping of /ClinicalDocument/code/@code to an Affinity Domain specified
coded value to use and coding system. Affinity Domains are encouraged to use the
appropriate value for Type of Service, based on the LOINC Type of Service (see
Page 53 of the LOINC User's Manual). Must be consistent with /ClinicalDocument/code/@code"/>
</mapping> </element> <element id="DocumentReference.subject"> <path value="DocumentReference.subject"/> <short value="Who/what is the subject of the document"/> <definition value="Who or what the document is about. The document can be about a person, (patient
or healthcare practitioner), a device (e.g. a machine) or even a group of subjects
(such as a document about a herd of farm animals, or a set of patients that share
a common exposure)."/>
<min value="0"/> <max value="1"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.subject"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.subject"/> </mapping> <mapping> <identity value="v2"/> <map value="PID-3 (No standard way to define a Practitioner or Group subject in HL7 V2 MDM
message)"/>
</mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode="SBJ"].role[typeCode="PAT"]"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.subject"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.patientId"/> </mapping> <mapping> <identity value="cda"/> <map value="ClinicalDocument/recordTarget/"/> </mapping> </element> <element id="DocumentReference.context"> <path value="DocumentReference.context"/> <short value="Encounter the document reference is part of"/> <definition value="The Encounter during which this document reference was created or to which the
creation of this record is tightly associated."/>
<comment value="This will typically be the encounter the document reference was created during,
but some document references may be initiated prior to or after the official completion
of an encounter but still be tied to the context of the encounter (e.g. pre-admission
lab tests)."/>
<requirements value="Links the document reference to the Encounter context. May also affect access
control."/>
<min value="0"/> <max value="*"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Appointment"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"/> </type> <condition value="docRef-1"/> <condition value="docRef-2"/> <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"/> <map value="unique(highest(./outboundRelationship[typeCode="SUBJ" and isNormalActRelationship()
], priorityNumber)/target[moodCode="EVN" and classCode=("ENC",
"PCPR") and isNormalAct])"/>
</mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.encounter"/> </mapping> </element> <element id="DocumentReference.event"> <path value="DocumentReference.event"/> <short value="Main clinical acts documented"/> <definition value="This list of codes represents the main clinical acts, such as a colonoscopy or
an appendectomy, being documented. In some cases, the event is inherent in the
type Code, such as a "History and Physical Report" in which the procedure
being documented is necessarily a "History and Physical" act."/>
<comment value="An event can further specialize the act inherent in the type, such as where it
is simply "Procedure Report" and the procedure was a "colonoscopy".
If one or more event codes are included, they shall not conflict with the values
inherent in the class or type elements as such a conflict would create an ambiguous
situation."/>
<min value="0"/> <max value="*"/> <type> <code value="CodeableReference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentEventType"/> </extension> <strength value="example"/> <description value="This list of codes represents the main clinical acts being documented."/> <valueSet value="http://terminology.hl7.org/ValueSet/v3-ActCode"/> </binding> <mapping> <identity value="rim"/> <map value=".code"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.event.detail"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.eventCodeList"/> </mapping> </element> <element id="DocumentReference.related"> <path value="DocumentReference.related"/> <short value="Related identifiers or resources associated with the document reference"/> <definition value="Any other resource this document reference was created or to which the creation
of this record is tightly associated."/>
<comment value="Use only for references not covered by other elements."/> <min value="0"/> <max value="*"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="./outboundRelationship[typeCode="PERT" and isNormalActRelationship()]
/ target[isNormalAct]"/>
</mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.event.detail"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.referenceIdList"/> </mapping> </element> <element id="DocumentReference.bodyStructure"> <path value="DocumentReference.bodyStructure"/> <short value="Body structure included"/> <definition value="The anatomic structures included in the document."/> <min value="0"/> <max value="*"/> <type> <code value="CodeableReference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/BodyStructure"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition"> <valueMarkdown value="Codes describing anatomical body structures. May include laterality."/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BodyStructure"/> </extension> <strength value="example"/> <description value="SNOMED CT Body Structures"/> <valueSet value="http://hl7.org/fhir/ValueSet/body-site"/> </binding> <mapping> <identity value="rim"/> <map value=".targetSiteCode"/> </mapping> </element> <element id="DocumentReference.facilityType"> <path value="DocumentReference.facilityType"/> <short value="Kind of facility where patient was seen"/> <definition value="The kind of facility where the patient was seen."/> <min value="0"/> <max value="1"/> <type> <code value="CodeableConcept"/> </type> <condition value="docRef-1"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentC80FacilityType"/> </extension> <strength value="example"/> <description value="XDS Facility Type."/> <valueSet value="http://hl7.org/fhir/ValueSet/c80-facilitycodes"/> </binding> <mapping> <identity value="rim"/> <map value=".participation[typeCode="LOC"].role[classCode="DSDLOC"].code"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="usually from a mapping to a local ValueSet"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.healthcareFacilityTypeCode"/> </mapping> <mapping> <identity value="cda"/> <map value="usually a mapping to a local ValueSet. Must be consistent with /clinicalDocument/code"/> </mapping> </element> <element id="DocumentReference.practiceSetting"> <path value="DocumentReference.practiceSetting"/> <short value="Additional details about where the content was created (e.g. clinical specialty)"/> <definition value="This property may convey specifics about the practice setting where the content
was created, often reflecting the clinical specialty."/>
<comment value="This element should be based on a coarse classification system for the class of
specialty practice. Recommend the use of the classification system for Practice
Setting, such as that described by the Subject Matter Domain in LOINC."/>
<requirements value="This is an important piece of metadata that providers often rely upon to quickly
sort and/or filter out to find specific content."/>
<min value="0"/> <max value="1"/> <type> <code value="CodeableConcept"/> </type> <condition value="docRef-2"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentC80PracticeSetting"/> </extension> <strength value="example"/> <description value="Additional details about where the content was created (e.g. clinical specialty)."/> <valueSet value="http://hl7.org/fhir/ValueSet/c80-practice-codes"/> </binding> <mapping> <identity value="rim"/> <map value=".participation[typeCode="LOC"].role[classCode="DSDLOC"].code"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="usually from a mapping to a local ValueSet"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.practiceSettingCode"/> </mapping> <mapping> <identity value="cda"/> <map value="usually from a mapping to a local ValueSet"/> </mapping> </element> <element id="DocumentReference.period"> <path value="DocumentReference.period"/> <short value="Time of service that is being documented"/> <definition value="The time period over which the service that is described by the document was provided."/> <min value="0"/> <max value="1"/> <type> <code value="Period"/> </type> <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"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.event.period"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.serviceStartTime, DocumentEntry.serviceStopTime"/> </mapping> <mapping> <identity value="cda"/> <map value="ClinicalDocument/documentationOf/
serviceEvent/effectiveTime/low/
@value --> ClinicalDocument/documentationOf/
serviceEvent/effectiveTime/high/
@value"/>
</mapping> </element> <element id="DocumentReference.date"> <path value="DocumentReference.date"/> <short value="When this document reference was created"/> <definition value="When the document reference was created."/> <comment value="Referencing/indexing time is used for tracking, organizing versions and searching.
Provide the most precise timestamp available."/>
<alias value="indexed"/> <min value="0"/> <max value="1"/> <type> <code value="dateTime"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.recorded"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.recorded"/> </mapping> <mapping> <identity value="rim"/> <map value=".availabilityTime[type="TS"]"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.date"/> </mapping> </element> <element id="DocumentReference.author"> <path value="DocumentReference.author"/> <short value="Who and/or what authored the document"/> <definition value="Identifies who is responsible for adding the information to the document."/> <comment value="Not necessarily who did the actual data entry (i.e. typist) or who was the source
(informant). Using Group is only allowed in the circumstance where the group represents
a family or a household, and should not represent groups of Practitioners. "/>
<min value="0"/> <max value="*"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> <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/CareTeam"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.performer.actor"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.author"/> </mapping> <mapping> <identity value="v2"/> <map value="TXA-9 (No standard way to indicate a Device in HL7 V2 MDM message)"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.author"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.author"/> </mapping> <mapping> <identity value="cda"/> <map value="ClinicalDocument/author"/> </mapping> </element> <element id="DocumentReference.attester"> <path value="DocumentReference.attester"/> <short value="Attests to accuracy of the document"/> <definition value="A participant who has authenticated the accuracy of the document."/> <comment value="Only list each attester once."/> <requirements value="Identifies responsibility for the accuracy of the document content."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Event.performer"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode="AUTHEN"].role[classCode="ASSIGNED"]"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.attester"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.legalAuthenticator"/> </mapping> <mapping> <identity value="cda"/> <map value=".authenticator/.legalAuthenticator"/> </mapping> </element> <element id="DocumentReference.attester.mode"> <path value="DocumentReference.attester.mode"/> <short value="personal | professional | legal | official"/> <definition value="The type of attestation the authenticator offers."/> <requirements value="Indicates the level of authority of the attestation."/> <min value="1"/> <max value="1"/> <type> <code value="CodeableConcept"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentAttestationMode"/> </extension> <strength value="preferred"/> <description value="The way in which a person authenticated a document."/> <valueSet value="http://hl7.org/fhir/ValueSet/composition-attestation-mode"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.performer.function"/> </mapping> <mapping> <identity value="rim"/> <map value="unique(./modeCode)"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.attester.mode"/> </mapping> <mapping> <identity value="cda"/> <map value="implied by .authenticator/.legalAuthenticator"/> </mapping> </element> <element id="DocumentReference.attester.time"> <path value="DocumentReference.attester.time"/> <short value="When the document was attested"/> <definition value="When the document was attested by the party."/> <requirements value="Identifies when the information in the document was deemed accurate. (Things may
have changed since then.)."/>
<min value="0"/> <max value="1"/> <type> <code value="dateTime"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="./time[type="TS" and isNormalDatatype()]"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.attester.time"/> </mapping> <mapping> <identity value="cda"/> <map value=".authenticator.time"/> </mapping> </element> <element id="DocumentReference.attester.party"> <path value="DocumentReference.attester.party"/> <short value="Who attested the document"/> <definition value="Who attested the document in the specified way."/> <comment value="Using Group is only allowed in the circumstance where the group represents a family
or a household, and should not represent groups of Practitioners. "/>
<requirements value="Identifies who has taken on the responsibility for accuracy of the document content."/> <min value="0"/> <max value="1"/> <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"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Event.performer.actor"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.witness"/> </mapping> <mapping> <identity value="v2"/> <map value="TXA-10"/> </mapping> <mapping> <identity value="rim"/> <map value="./role[classCode="ASSIGNED" and isNormalRole]/player[determinerCode="INST"
; and classCode=("DEV", "PSN") and isNormalEntity()] or ./role[classCode=&
quot;ASSIGNED" and isNormalRole and not(player)]/scoper[determinerCode="INST"
and classCode="ORG" and isNormalEntity()]"/>
</mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.attester.party"/> </mapping> <mapping> <identity value="cda"/> <map value=".authenticator.assignedEnttty"/> </mapping> </element> <element id="DocumentReference.custodian"> <path value="DocumentReference.custodian"/> <short value="Organization which maintains the document"/> <definition value="Identifies the organization or group who is responsible for ongoing maintenance
of and access to the document."/>
<comment value="Identifies the logical organization (software system, vendor, or department) to
go to find the current version, where to report issues, etc. This is different
from the physical location (URL, disk drive, or server) of the document, which
is the technical location of the document, which host may be delegated to the management
of some other organization."/>
<min value="0"/> <max value="1"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".participation[typeCode="RCV"].role[classCode="CUST"].scoper[classCode=&q
uot;ORG" and determinerCode="INST"]"/>
</mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.custodian"/> </mapping> </element> <element id="DocumentReference.relatesTo"> <path value="DocumentReference.relatesTo"/> <short value="Relationships to other documents"/> <definition value="Relationships that this document has with other document references that already
exist."/>
<comment value="This element is labeled as a modifier because documents that append to other documents
are incomplete on their own."/>
<min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value=".outboundRelationship"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.relatesTo"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry Associations"/> </mapping> </element> <element id="DocumentReference.relatesTo.code"> <path value="DocumentReference.relatesTo.code"/> <short value="The relationship type with another document"/> <definition value="The type of relationship that this document has with anther document."/> <comment value="If this document appends another document, then the document cannot be fully understood
without also accessing the referenced document."/>
<min value="1"/> <max value="1"/> <type> <code value="CodeableConcept"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentRelationshipType"/> </extension> <strength value="extensible"/> <description value="The type of relationship between the documents."/> <valueSet value="http://hl7.org/fhir/ValueSet/document-relationship-type"/> </binding> <mapping> <identity value="rim"/> <map value=".outboundRelationship.typeCode"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.relatesTo.type"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry Associations type"/> </mapping> <mapping> <identity value="cda"/> <map value="ClinicalDocument/relatedDocument/typeCode"/> </mapping> </element> <element id="DocumentReference.relatesTo.target"> <path value="DocumentReference.relatesTo.target"/> <short value="Target of the relationship"/> <definition value="The target document of this relationship."/> <min value="1"/> <max value="1"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value=".target[classCode="DOC", moodCode="EVN"].id"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.relatesTo.targetReference"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry Associations reference"/> </mapping> <mapping> <identity value="cda"/> <map value="ClinicalDocument/relatedDocument/parentDocument"/> </mapping> </element> <element id="DocumentReference.description"> <path value="DocumentReference.description"/> <short value="Human-readable description"/> <definition value="Human-readable description of the source document."/> <comment value="What the document is about, a terse summary of the document."/> <requirements value="Helps humans to assess whether the document is of interest."/> <min value="0"/> <max value="1"/> <type> <code value="markdown"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="TXA-25"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode="SUBJ"].target.text"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.comments"/> </mapping> </element> <element id="DocumentReference.securityLabel"> <path value="DocumentReference.securityLabel"/> <short value="Document security-tags"/> <definition value="A set of Security-Tag codes specifying the level of privacy/security of the Document
found at DocumentReference.content.attachment.url. Note that DocumentReference.meta.security
contains the security labels of the data elements in DocumentReference, while DocumentReferen
ce.securityLabel contains the security labels for the document the reference refers
to. The distinction recognizes that the document may contain sensitive information,
while the DocumentReference is metadata about the document and thus might not be
as sensitive as the document. For example: a psychotherapy episode may contain
highly sensitive information, while the metadata may simply indicate that some
episode happened."/>
<comment value="The confidentiality codes can carry multiple vocabulary items. HL7 has developed
an understanding of security and privacy tags that might be desirable in a Document
Sharing environment, called HL7 Healthcare Privacy and Security Classification
System (HCS). The following specification is recommended but not mandated, as the
vocabulary bindings are an administrative domain responsibility. The use of this
method is up to the policy domain such as the XDS Affinity Domain or other Trust
Domain where all parties including sender and recipients are trusted to appropriately
tag and enforce.
In the HL7 Healthcare Privacy and Security Classification (HCS) there are code
systems specific to Confidentiality, Sensitivity, Integrity, and Handling Caveats.
Some values would come from a local vocabulary as they are related to workflow
roles and special projects."/>
<requirements value="Use of the Health Care Privacy/Security Classification (HCS) system of security-tag
use is recommended."/>
<min value="0"/> <max value="*"/> <type> <code value="CodeableConcept"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="SecurityLabels"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="example"/> <description value="Example Security Labels from the Healthcare Privacy and Security Classification
System."/>
<valueSet value="http://hl7.org/fhir/ValueSet/security-label-example"/> </binding> <mapping> <identity value="v2"/> <map value="TXA-18"/> </mapping> <mapping> <identity value="rim"/> <map value=".confidentialityCode"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Bundle.meta.security"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.confidentialityCode"/> </mapping> <mapping> <identity value="cda"/> <map value="ClinicalDocument/confidentialityCode/@code"/> </mapping> </element> <element id="DocumentReference.content"> <path value="DocumentReference.content"/> <short value="Document referenced"/> <definition value="The document and format referenced. If there are multiple content element repetitions,
these must all represent the same document in different format, or attachment metadata."/>
<comment value="content element shall not contain different versions of the same content. For version
handling use multiple DocumentReference with .relatesTo."/>
<requirements value="Note that .relatesTo may also include references to other DocumentReference with
a transforms relationship to represent the same document in multiple formats."/>
<min value="1"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="document.text"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Bundle(Composition+*)"/> </mapping> </element> <element id="DocumentReference.content.attachment"> <path value="DocumentReference.content.attachment"/> <short value="Where to access the document"/> <definition value="The document or URL of the document along with critical metadata to prove content
has integrity."/>
<min value="1"/> <max value="1"/> <type> <code value="Attachment"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="TXA-3 for mime type"/> </mapping> <mapping> <identity value="rim"/> <map value="document.text"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.language,
Composition.title,
Composition.date"/>
</mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.mimeType, DocumentEntry.languageCode, DocumentEntry.repositoryUniqueId,
DocumentEntry.URI, DocumentEntry.size, DocumentEntry.hash, DocumentEntry.title,
DocumentEntry.creationTime"/>
</mapping> <mapping> <identity value="cda"/> <map value="ClinicalDocument/languageCode, ClinicalDocument/title, ClinicalDocument/date"/> </mapping> </element> <element id="DocumentReference.content.profile"> <path value="DocumentReference.content.profile"/> <short value="Content profile rules for the document"/> <definition value="An identifier of the document constraints, encoding, structure, and template that
the document conforms to beyond the base format indicated in the mimeType."/>
<comment value="Note that IHE often issues URNs for formatCode codes, not all documents can be
identified by a URI.
For FHIR content, .profile should indicate the structureDefinition profile canonical
URI(s) that the content complies with."/>
<alias value="format"/> <alias value="formatCode"/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="document.text"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.meta.profile"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.formatCode"/> </mapping> <mapping> <identity value="cda"/> <map value="derived from the IHE Profile or Implementation Guide templateID"/> </mapping> </element> <element id="DocumentReference.content.profile.value[x]"> <path value="DocumentReference.content.profile.value[x]"/> <short value="Code|uri|canonical"/> <definition value="Code|uri|canonical."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <type> <code value="uri"/> </type> <type> <code value="canonical"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentFormat"/> </extension> <strength value="preferred"/> <description value="Document Format Codes."/> <valueSet value="http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes"/> </binding> <mapping> <identity value="rim"/> <map value="document.text"/> </mapping> <mapping> <identity value="fhircomposition"/> <map value="Composition.meta.profile"/> </mapping> <mapping> <identity value="xds"/> <map value="DocumentEntry.formatCode"/> </mapping> <mapping> <identity value="cda"/> <map value="derived from the IHE Profile or Implementation Guide templateID"/> </mapping> </element> </differential>
</
StructureDefinition
>
Usage
note:
every
effort
has
been
made
to
ensure
that
the
examples
are
correct
and
useful,
but
they
are
not
a
normative
part
of
the
specification.