FHIR CI-Build

This is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
See the Directory of published versions

Example StructureDefinition/DocumentReference (XML)

Orders and Observations Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Device, Encounter, Patient, Practitioner, RelatedPerson

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

Jump past Narrative

StructureDefinition for documentreference

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

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="DocumentReference"/> 
  <meta> 
    <lastUpdated value="2024-07-19T15:58:43.721+00:00"/> 
  </meta> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
      <table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align:
       top;">
        <tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align:
         top">
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a> 
          </th> 
          <th class="hierarchy" style="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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description &amp; Constraints</a> 
            <span style="float: right">
              <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format">
                <img alt="doco" src="data:(snipped in html view)" style="background-color: inherit"/> 
              </a> 
            </span> 
          </th> 
        </tr> 
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAJUlEQVR4Xu3IIQEAAAgDsHd9/w4EQIOamFnaBgAA4M
          MKAACAKwNp30CqZFfFmwAAAABJRU5ErkJggg==)">
            <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 &quot;document&quot;
             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 : 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: #fff5e6" title="Standards Status = Trial Use">TU</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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.">implicitRules</a> , 
            <a href="resource.html#Resource" title="The base language in which the resource is written.">language</a> , 
            <a href="domainresource.html#DomainResource" title="A human-readable narrative that contains a summary of the resource and can be used
             to represent the content of the resource to a human. The narrative need not encode
             all the structured data, but is required to contain sufficient detail to make it
             &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions
             may define what content should be represented in the narrative to ensure clinical
             safety.">text</a> , 
            <a href="domainresource.html#DomainResource" title="These resources do not have an independent existence apart from the resource that
             contains them - they cannot be identified independently, nor can they have their
             own independent transaction scope. This is allowed to be a Parameters resource
             if and only if it is referenced by a resource that provides context/meaning.">contained</a> , 
            <a href="domainresource.html#DomainResource" title="May be used to represent additional information that is not part of the basic definition
             of the resource. To make the use of extensions safe and 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 : 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 : 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <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 : 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : 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 : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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="immunizationrecommendation.html">ImmunizationRecommendation</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="supplyrequest.html">SupplyRequest</a>  | 
            <a href="visionprescription.html">VisionPrescription</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <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 : 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" 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : 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 : 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" 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <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 : 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <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 : 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <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 : 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" 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;" title="This element has or is affected by some invariants">C</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 &quot;History and Physical Report&quot;
             in which the procedure being documented is necessarily a &quot;History and Physical&quot;
             act.">event</span> 
            <a name="DocumentReference.event"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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/6.0.0/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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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.bodySite : The anatomic structures included in the document.">bodySite</span> 
            <a name="DocumentReference.bodySite"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Body part included
            <br/>  Binding: 
            <a href="valueset-body-site.html" title="Codes describing anatomical locations. 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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <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 : 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;" title="This element has or is affected by some invariants">C</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : 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 : 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;" title="This element has or is affected by some invariants">C</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <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 : 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : 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 : 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <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 : 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAMUlEQVR4Xu3LMQoAIBADwftr/v8GtdbqEAthAtMspJ
          JUx9rYW8ftHwAA+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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : 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 : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <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 : 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <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 : 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : 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 : 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <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 : 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Document security-tags
            <br/>  Binding: 
            <a href="valueset-security-label-examples.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 : 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 : 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">1..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAwEsez6+89AqKGGJj7JzVWS+m
          m3zgcAAMxwDQAAgFcaYAVAgNGLTjgAAAAASUVORK5CYII=)">
            <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 : 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : 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 : 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAwEsez6+89AqKGGJj7JzVWSmm
          S3zgcAAPxxDQAAgFcadQVAgPvMVYYAAAAASUVORK5CYII=)">
            <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 : 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" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Code|uri|canonical
            <br/>  Binding: 
            <a href="http://terminology.hl7.org/6.0.0/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 : 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 : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAwEsez6+89AqKGGJj7JzVWSmm
          S3zgcAAPxxDQAAgFcadQVAgPvMVYYAAAAASUVORK5CYII=)">
            <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 : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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 : 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 : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : 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 : 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-standards-status">
    <valueCode value="trial-use"/> 
  </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="4"/> 
  </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-cibuild"/> 
  <name value="DocumentReference"/> 
  <status value="draft"/> 
  <experimental value="false"/> 
  <date value="2024-07-19T15:58:43+00:00"/> 
  <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-cibuild"/> 
  <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="fhircomposition"/> 
    <uri value="http://hl7.org/fhir/composition"/> 
    <name value="FHIR Composition"/> 
  </mapping> 
  <mapping> 
    <identity value="rim"/> 
    <uri value="http://hl7.org/v3"/> 
    <name value="RIM Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="xds"/> 
    <uri value="http://ihe.net/xds"/> 
    <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 &quot;document&quot; 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 in (%resource.descendants().reference | %resource.descendants().ofTy
        pe(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url)))
         or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical)
         = '#').exists() or descendants().where(ofType(canonical) = '#').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=&quot;DOC&quot; and moodCode=&quot;EVN&quot;]"/> 
      </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> 
      <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler
       magic (j)  -->
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/> 
        </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() &gt; 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."/> 
      <comment value="Asserting this rule set restricts the content to be only understood by a limited
       set of trading partners. This inherently limits the usefulness of the data in the
       long term. However, the existing health eco-system is highly fractured, and not
       yet ready to define, collect, and exchange data in a generally computable sense.
       Wherever possible, implementers and/or specification writers should avoid using
       this element. Often, when used, the URL is a reference to an implementation guide
       that defines these special rules as part of its narrative along with other profiles,
       value sets, etc."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.implicitRules"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional
       knowledge about the resource that modifies 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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="required"/> 
        <description value="IETF language tag for a human language"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/all-languages|6.0.0-cibuild"/> 
        <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
       &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions
       may define what content should be represented in the narrative to ensure clinical
       safety."/> 
      <comment value="Contained resources do not have a narrative. Resources that are not contained SHOULD
       have a narrative. In some cases, a resource may only have text with little or no
       additional discrete data (as long as all minOccurs=1 elements are satisfied). 
       This may be necessary for data from legacy systems where information is captured
       as a &quot;text blob&quot; or where text is additionally entered raw or narrated
       and encoded information is added later."/> 
      <alias value="narrative"/> 
      <alias value="html"/> 
      <alias value="xhtml"/> 
      <alias value="display"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DomainResource.text"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Narrative"/> 
      </type> 
      <condition value="dom-6"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Act.text?"/> 
      </mapping> 
    </element> 
    <element id="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."/> 
      <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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       resource that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="fhircomposition"/> 
        <map value="Composition.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="TXA-12"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id / .setId"/> 
      </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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.version"/> 
      </mapping> 
      <mapping> 
        <identity value="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/ImmunizationRecommendation"/> 
        <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/SupplyRequest"/> 
        <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() &gt; 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() &gt; 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-cibuild"/> 
      </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=&quot;IN&quot; &amp; ./statusCode[isNormalDatatype()]=&quot;active&q
        uot;;  final: .completionCode=&quot;AU&quot; &amp;&amp;  ./statusCode[isNormalDatatype()]=&quo
        t;complete&quot; and not(./inboundRelationship[typeCode=&quot;SUBJ&quot; and isNormalActRelati
        onship()]/source[subsumesCode(&quot;ActClass#CACT&quot;) and moodCode=&quot;EVN&quot;
         and domainMember(&quot;ReviseDocument&quot;, code) and isNormalAct()]);  amended:
         .completionCode=&quot;AU&quot; &amp;&amp;  ./statusCode[isNormalDatatype()]=&quot;complete&qu
        ot; and ./inboundRelationship[typeCode=&quot;SUBJ&quot; and isNormalActRelationship()]/source[
        subsumesCode(&quot;ActClass#CACT&quot;) and moodCode=&quot;EVN&quot; and domainMember(&quot;Re
        viseDocument&quot;, code) and isNormalAct() and statusCode=&quot;completed&quot;];
          withdrawn : .completionCode=NI &amp;&amp;  ./statusCode[isNormalDatatype()]=&quot;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() &gt; 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-cibuild"/> 
      </binding> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.status"/> 
      </mapping> 
      <mapping> 
        <identity value="fhircomposition"/> 
        <map value="Composition.status"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="TXA-17"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".statusCode"/> 
      </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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DocumentType"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="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="fhircomposition"/> 
        <map value="Composition.type"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="TXA-2"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="./code"/> 
      </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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="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="fhircomposition"/> 
        <map value="Composition.category"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=&quot;COMP].target[classCode=&quot;LIST&quot;, moodCode=&quot;
        EVN&quot;].code"/> 
      </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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.subject"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="fhircomposition"/> 
        <map value="Composition.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=&quot;SBJ&quot;].role[typeCode=&quot;PAT&quot;]"/> 
      </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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.encounter"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.context"/> 
      </mapping> 
      <mapping> 
        <identity value="fhircomposition"/> 
        <map value="Composition.encounter"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="unique(highest(./outboundRelationship[typeCode=&quot;SUBJ&quot; and isNormalActRelationship()
        ], priorityNumber)/target[moodCode=&quot;EVN&quot; and classCode=(&quot;ENC&quot;,
         &quot;PCPR&quot;) and isNormalAct])"/> 
      </mapping> 
    </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 &quot;History and Physical Report&quot; in which the procedure
       being documented is necessarily a &quot;History and Physical&quot; act."/> 
      <comment value="An event can further specialize the act inherent in the type, such as  where it
       is simply &quot;Procedure Report&quot; and the procedure was a &quot;colonoscopy&quot;.
       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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="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="fhircomposition"/> 
        <map value="Composition.event.detail"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="fhircomposition"/> 
        <map value="Composition.event.detail"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="./outboundRelationship[typeCode=&quot;PERT&quot; and isNormalActRelationship()]
         / target[isNormalAct]"/> 
      </mapping> 
      <mapping> 
        <identity value="xds"/> 
        <map value="DocumentEntry.referenceIdList"/> 
      </mapping> 
    </element> 
    <element id="DocumentReference.bodySite">
      <path value="DocumentReference.bodySite"/> 
      <short value="Body part included"/> 
      <definition value="The anatomic structures included in the document."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DocumentReference.bodySite"/> 
        <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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueMarkdown value="Codes describing anatomical locations. May include laterality."/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="BodySite"/> 
        </extension> 
        <strength value="example"/> 
        <description value="SNOMED CT Body site concepts"/> 
        <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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DocumentC80FacilityType"/> 
        </extension> 
        <strength value="example"/> 
        <description value="XDS Facility Type."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/c80-facilitycodes"/> 
      </binding> 
      <mapping> 
        <identity value="fhircomposition"/> 
        <map value="usually from a mapping to a local ValueSet"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=&quot;LOC&quot;].role[classCode=&quot;DSDLOC&quot;].code"/> 
      </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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="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="fhircomposition"/> 
        <map value="usually from a mapping to a local ValueSet"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=&quot;LOC&quot;].role[classCode=&quot;DSDLOC&quot;].code"/> 
      </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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.occurrence[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.done[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="fhircomposition"/> 
        <map value="Composition.event.period"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime"/> 
      </mapping> 
      <mapping> 
        <identity value="xds"/> 
        <map value="DocumentEntry.serviceStartTime, DocumentEntry.serviceStopTime"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value="ClinicalDocument/documentationOf/
serviceEvent/effectiveTime/low/
@value --&gt; 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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.recorded"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.recorded"/> 
      </mapping> 
      <mapping> 
        <identity value="fhircomposition"/> 
        <map value="Composition.date"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".availabilityTime[type=&quot;TS&quot;]"/> 
      </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)."/> 
      <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"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.performer.actor"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.author"/> 
      </mapping> 
      <mapping> 
        <identity value="fhircomposition"/> 
        <map value="Composition.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=&quot;AUT&quot;].role[classCode=&quot;ASSIGNED&quot;]"/> 
      </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"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="fhircomposition"/> 
        <map value="Composition.attester"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=&quot;AUTHEN&quot;].role[classCode=&quot;ASSIGNED&quot;]"/> 
      </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> 
      <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler
       magic (j)  -->
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="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="fhircomposition"/> 
        <map value="Composition.attester.mode"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="unique(./modeCode)"/> 
      </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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="fhircomposition"/> 
        <map value="Composition.attester.time"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="./time[type=&quot;TS&quot; and isNormalDatatype()]"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".authenticator.time"/> 
      </mapping> 
    </element> 
    <element id="DocumentReference.attester.party">
      <path value="DocumentReference.attester.party"/> 
      <short value="Who attested the document"/> 
      <definition value="Who attested the document in the specified way."/> 
      <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"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.witness"/> 
      </mapping> 
      <mapping> 
        <identity value="fhircomposition"/> 
        <map value="Composition.attester.party"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="TXA-10"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="./role[classCode=&quot;ASSIGNED&quot; and isNormalRole]/player[determinerCode=&quot;INST&quot
        ; and classCode=(&quot;DEV&quot;, &quot;PSN&quot;) and isNormalEntity()] or ./role[classCode=&
        quot;ASSIGNED&quot; and isNormalRole and not(player)]/scoper[determinerCode=&quot;INST&quot;
         and classCode=&quot;ORG&quot; and isNormalEntity()]"/> 
      </mapping> 
      <mapping> 
        <identity value="cda"/> 
        <map value=".authenticator.assignedEnttty"/> 
      </mapping> 
    </element> 
    <element id="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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="fhircomposition"/> 
        <map value="Composition.custodian"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=&quot;RCV&quot;].role[classCode=&quot;CUST&quot;].scoper[classCode=&q
        uot;ORG&quot; and determinerCode=&quot;INST&quot;]"/> 
      </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"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="fhircomposition"/> 
        <map value="Composition.relatesTo"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship"/> 
      </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> 
      <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler
       magic (j)  -->
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="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="fhircomposition"/> 
        <map value="Composition.relatesTo.type"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship.typeCode"/> 
      </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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="fhircomposition"/> 
        <map value="Composition.relatesTo.resourceReference"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".target[classCode=&quot;DOC&quot;, moodCode=&quot;EVN&quot;].id"/> 
      </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() &gt; 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=&quot;SUBJ&quot;].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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="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-examples"/> 
      </binding> 
      <mapping> 
        <identity value="fhircomposition"/> 
        <map value="Bundle.meta.security"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="TXA-18"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".confidentialityCode"/> 
      </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"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="fhircomposition"/> 
        <map value="Bundle(Composition+*)"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="document.text"/> 
      </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> 
      <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler
       magic (j)  -->
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="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() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="fhircomposition"/> 
        <map value="Composition.language, 
Composition.title, 
Composition.date"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="TXA-3 for mime type"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="document.text"/> 
      </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"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="fhircomposition"/> 
        <map value="Composition.meta.profile"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="document.text"/> 
      </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> 
      <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler
       magic (j)  -->
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="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."/> <