## Profile Comparison between http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference vs http://hl7.org/fhir/us/pq-cmc-fda/StructureDefinition/pqcmc-structure-reference

Left: | US Core DocumentReference Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference)
Right: | Structure Data Reference (http://hl7.org/fhir/us/pq-cmc-fda/StructureDefinition/pqcmc-structure-reference)

### Messages

Error | StructureDefinition.url | Values for url differ: 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference' vs 'http://hl7.org/fhir/us/pq-cmc-fda/StructureDefinition/pqcmc-structure-reference'
Error | StructureDefinition.version | Values for version differ: '8.0.0' vs '2.0.0'
Information | StructureDefinition.name | Values for name differ: 'USCoreDocumentReferenceProfile' vs 'StructureReference'
Information | StructureDefinition.title | Values for title differ: 'US Core DocumentReference Profile' vs 'Structure Data Reference'
Information | StructureDefinition.date | Values for date differ: '2023-10-17' vs '2025-07-03T13:07:08+00:00'
Information | StructureDefinition.publisher | Values for publisher differ: 'HL7 International / Cross-Group Projects' vs 'HL7 International / Biomedical Research and Regulation'
Warning | StructureDefinition.fhirVersion | Values for fhirVersion differ: '4.0.1' vs '5.0.0'
Warning | StructureDefinition.abstract | Values for abstract differ: 'false' vs 'true'
Error | StructureDefinition.baseDefinition | Values for baseDefinition differ: 'http://hl7.org/fhir/StructureDefinition/DocumentReference' vs 'http://hl7.org/fhir/us/pq-cmc-fda/StructureDefinition/cmc-document-reference'
Information | StructureDefinition.definition | Values for definition differ: 'A reference to a document of any kind for any purpose. Provides metadata about the document so that the document can be discovered and managed. The scope of a document is any seralized object with a mime-type, so includes formal patient centric documents (CDA), cliical notes, scanned paper, and non-patient specific documents like policy text.' vs '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.'
Information | StructureDefinition.comment | Values for comment differ: 'The only time that a resource does not have an id is when it is being submitted to the server using a create operation.' vs '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.'
Information | StructureDefinition.comment | Values for comment differ: 'Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.' vs '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.'
Information | StructureDefinition.comment | Values for comment differ: 'Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a 'text blob' or where text is additionally entered raw or narrated and encoded information is added later.' vs 'Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a 'text blob' or where text is additionally entered raw or narrated and encoded information is added later.'
Information | StructureDefinition.definition | Values for definition differ: 'These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.' vs '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.'
Information | StructureDefinition.comment | Values for comment differ: '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.' vs '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.'
Information | StructureDefinition.definition | Values for definition differ: 'May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.' vs '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.'
Information | StructureDefinition.definition | Values for definition differ: 'May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).' vs '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).'
Information | StructureDefinition.requirements | Values for requirements differ: '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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).' vs '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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).'
Information | StructureDefinition.short | Values for short differ: 'Other identifiers for the document' vs 'Business identifiers for the document'
Information | StructureDefinition.definition | Values for definition differ: 'Other identifiers associated with the document, including version independent identifiers.' vs 'Other business identifiers associated with the document, including version independent identifiers.'
Warning | DocumentReference.identifier | Elements differ in definition for mustSupport: 'true' vs 'false'
Warning | DocumentReference.status | Elements differ in definition for mustSupport: 'true' vs 'false'
Information | StructureDefinition.short | Values for short differ: 'preliminary | final | amended | entered-in-error' vs 'registered | partial | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | deprecated | unknown'
Error | DocumentReference.docStatus | Unable to resolve left value set http://hl7.org/fhir/ValueSet/composition-status|4.0.1 at DocumentReference.docStatus
Warning | DocumentReference.type | Elements differ in definition for mustSupport: 'true' vs 'false'
Information | DocumentReference.type | Element minimum cardinalities differ: '1' vs '0'
Warning | DocumentReference.category | Elements differ in definition for mustSupport: 'true' vs 'false'
Information | DocumentReference.category | Element minimum cardinalities differ: '1' vs '0'
Warning | DocumentReference.subject | Elements differ in definition for mustSupport: 'true' vs 'false'
Information | DocumentReference.subject | Element minimum cardinalities differ: '1' vs '0'
Warning | DocumentReference.date | Elements differ in definition for mustSupport: 'true' vs 'false'
Warning | DocumentReference.author | Elements differ in definition for mustSupport: 'true' vs 'false'
Information | StructureDefinition.definition | Values for definition differ: 'May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.' vs '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.'
Information | StructureDefinition.definition | Values for definition differ: 'May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).' vs '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).'
Information | StructureDefinition.requirements | Values for requirements differ: '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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).' vs '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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).'
Information | StructureDefinition.short | Values for short differ: 'replaces | transforms | signs | appends' vs 'The relationship type with another document'
Error | DocumentReference.relatesTo.code | Unable to resolve left value set http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 at DocumentReference.relatesTo.code
Information | StructureDefinition.definition | Values for definition differ: 'A set of Security-Tag codes specifying the level of privacy/security of the Document. Note that DocumentReference.meta.security contains the security labels of the 'reference' to the document, while DocumentReference.securityLabel contains a snapshot of the security labels on the document the reference refers to.' vs '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.'
Information | StructureDefinition.definition | Values for definition differ: 'The document and format referenced. There may be multiple content element repetitions, each with a different format.' vs '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.'
Information | StructureDefinition.definition | Values for definition differ: 'May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.' vs '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.'
Information | StructureDefinition.definition | Values for definition differ: 'May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).' vs '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).'
Information | StructureDefinition.requirements | Values for requirements differ: '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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).' vs '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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).'
Information | StructureDefinition.definition | Values for definition differ: 'The document and format referenced.' vs 'The document or URL of the document along with critical metadata to prove content has integrity.'
Information | StructureDefinition.short | Values for short differ: 'Clinical context of document' vs 'Context of the document content'
Information | StructureDefinition.definition | Values for definition differ: 'The clinical context in which the document was prepared.' vs 'Describes the clinical encounter or type of care that the document content is associated with.'
Warning | DocumentReference.context | Elements differ in definition for mustSupport: 'true' vs 'false'
Information | DocumentReference.context | Element maximum cardinalities differ: '1' vs '2147483647'

### Metadata

Name | Value | Comments
--- | --- | ---
abstract | false | true | Values Differ
baseDefinition | http://hl7.org/fhir/StructureDefinition/DocumentReference | http://hl7.org/fhir/us/pq-cmc-fda/StructureDefinition/cmc-document-reference | Values Differ
copyright | Used by permission of HL7 International, all rights reserved Creative Commons License |  | Removed the item 'Used by permission of HL7 International, all rights reserved Creative Commons License'
date | 2023-10-17 | 2025-07-03T13:07:08+00:00 | Values Differ
description | The US Core DocumentReference Profile inherits from the FHIR [DocumentReference](https://hl7.org/fhir/R4/documentreference.html) resource; refer to it for scope and usage definitions. This profile sets minimum expectations for searching and fetching patient documents including Clinical Notes using the DocumentReference resource. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption. Before reviewing this profile, implementers are encouraged to read the Clinical Notes Guidance to understand the overlap of the US Core DiagnosticReport Profile for Report and Note exchange and the US Core DocumentReference Profile. | A Document Reference to any attachment that contains structure data | Values Differ
experimental | false |  | Removed the item 'false'
fhirVersion | 4.0.1 | 5.0.0 | Values Differ
jurisdiction |  |
jurisdiction[0] | urn:iso:std:iso:3166#US |
kind | resource |
name | USCoreDocumentReferenceProfile | StructureReference | Values Differ
publisher | HL7 International / Cross-Group Projects | HL7 International / Biomedical Research and Regulation | Values Differ
purpose |  |
status | active |
title | US Core DocumentReference Profile | Structure Data Reference | Values Differ
type | DocumentReference |
url | http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference | http://hl7.org/fhir/us/pq-cmc-fda/StructureDefinition/pqcmc-structure-reference | Values Differ
version | 8.0.0 | 2.0.0 | Values Differ

### Structure

Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments
--- | --- | --- | --- | --- | --- | --- | --- | --- | ---
DocumentReference |  | 0..* | DocumentReference | A reference to a document | C | 0..* | Base64DocumentReference | This is an abstract profile. A reference to a document |
id | Σ | 0..1 | id | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact |
meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
language |  | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | Max Binding
|  | 0..1 | code | Language of the resource content Binding: ?? (required): IETF language tag for a human language
Additional Bindings | Purpose
?? | Starter
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements |
contained |  | 0..* | Resource | Contained, inline Resources |  | 0..* | Resource | Contained, inline Resources |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
masterIdentifier | Σ | 0..1 | Identifier | Master Version Specific Identifier |  |  |  |  | Removed this element
identifier | S Σ | 0..* | Identifier | Other identifiers for the document | Σ | 0..* | Identifier | Business identifiers for the document | Elements differ in definition for mustSupport: 'true' vs 'false'
status | ?!S Σ | 1..1 | code | current | superseded | entered-in-error Binding: ?? (required) | ?!Σ | 1..1 | code | current | superseded | entered-in-error Binding: ?? (required): The status of the document reference. Required Pattern: current | Elements differ in definition for mustSupport: 'true' vs 'false'
docStatus | Σ | 0..1 | code | preliminary | final | amended | entered-in-error Binding: ?? (required): Status of the underlying document. | Σ | 0..1 | code | registered | partial | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | deprecated | unknown Binding: ?? (required): Status of the underlying document. | Unable to resolve left value set http://hl7.org/fhir/ValueSet/composition-status|4.0.1 at DocumentReference.docStatus
type | S Σ | 1..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: ?? (required): All LOINC values whose SCALE is "Doc" in the LOINC database and the HL7 v3 Code System NullFlavor concept 'unknown'
Additional Bindings | Purpose
?? | Min Binding
| Σ | 0..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: ?? (preferred): Precise type of clinical document. | Elements differ in definition for mustSupport: 'true' vs 'false' Element minimum cardinalities differ: '1' vs '0'
Slices for category | S Σ | 1..* | CodeableConcept | Categorization of document Slice: Unordered, Open by value:$this Binding: ?? (example): High-level kind of a clinical document at a macro level. | Σ | 0..* | CodeableConcept | Categorization of document Binding: ?? (example): High-level kind of document at a macro level. | Elements differ in definition for mustSupport: 'true' vs 'false' Element minimum cardinalities differ: '1' vs '0'
subject | S Σ | 1..1 | Reference(US Core Patient Profile S | Practitioner | Group | Device) | Who/what is the subject of the document | Σ | 0..1 | Reference(Resource) | Who/what is the subject of the document | Elements differ in definition for mustSupport: 'true' vs 'false' Element minimum cardinalities differ: '1' vs '0'
date | S Σ | 0..1 | instant | When this document reference was created | Σ | 0..1 | instant | When this document reference was created | Elements differ in definition for mustSupport: 'true' vs 'false'
author | S Σ | 0..* | Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device) | Who and/or what authored the document | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson | CareTeam) | Who and/or what authored the document | Elements differ in definition for mustSupport: 'true' vs 'false'
authenticator |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Who/what authenticated the document |  |  |  |  | Removed this element
custodian |  | 0..1 | Reference(Organization) | Organization which maintains the document |  | 0..1 | Reference(Organization) | Organization which maintains the document |
relatesTo | Σ | 0..* | BackboneElement | Relationships to other documents | Σ | 0..* | BackboneElement | Relationships to other documents |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
code | Σ | 1..1 | code | replaces | transforms | signs | appends Binding: ?? (required): The type of relationship between documents. | Σ | 1..1 | CodeableConcept | The relationship type with another document Binding: ?? (extensible): The type of relationship between the documents. | Unable to resolve left value set http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 at DocumentReference.relatesTo.code
target | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship |
description | Σ | 0..1 | string | Human-readable description | Σ | 0..1 | markdown | Human-readable description |
securityLabel | Σ | 0..* | CodeableConcept | Document security-tags Binding: ?? (extensible): Security Labels from the Healthcare Privacy and Security Classification System. | Σ | 0..* | CodeableConcept | Document security-tags Binding: ?? (example): Example Security Labels from the Healthcare Privacy and Security Classification System. |
content | S Σ | 1..* | BackboneElement | Document referenced | S Σ | 1..* | BackboneElement | Document referenced |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
attachment | S Σ C | 1..1 | Attachment | Where to access the document Constraints: us-core-6 | S Σ | 1..1 | ?? | Where to access the document |
id |  | 0..1 | string | Unique id for inter-element referencing |  |  |  |  | Removed this element
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |  |  |  |  | Removed this element
contentType | S Σ | 0..1 | code | Mime type of the content, with charset etc. Binding: ?? (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png |  |  |  |  | Removed this element
language | Σ | 0..1 | code | Human language of the content (BCP-47) Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | Max Binding
Example General: en-AU |  |  |  |  | Removed this element
data | S C | 0..1 | base64Binary | Data inline, base64ed |  |  |  |  | Removed this element
url | S Σ C | 0..1 | url | Uri where the data can be found Example General: http://www.acme.com/logo-small.png |  |  |  |  | Removed this element
size | Σ | 0..1 | unsignedInt | Number of bytes of content (if url provided) |  |  |  |  | Removed this element
hash | Σ | 0..1 | base64Binary | Hash of the data (sha-1, base64ed) |  |  |  |  | Removed this element
title | Σ | 0..1 | string | Label to display in place of the data Example General: Official Corporate Logo |  |  |  |  | Removed this element
creation | Σ | 0..1 | dateTime | Date attachment was first created |  |  |  |  | Removed this element
format | S Σ | 0..1 | Coding | Format/content rules for the document Binding: ?? (extensible) |  |  |  |  | Removed this element
profile |  |  |  |  | Σ | 0..* | BackboneElement | Content profile rules for the document | Added this element
context | S Σ | 0..1 | BackboneElement | Clinical context of document | C | 0..* | Reference(Appointment | Encounter | EpisodeOfCare) | Context of the document content | Elements differ in definition for mustSupport: 'true' vs 'false' Element maximum cardinalities differ: '1' vs '2147483647'
id |  | 0..1 | string | Unique id for inter-element referencing |  |  |  |  | Removed this element
extension |  | 0..* | Extension | Additional content defined by implementations |  |  |  |  | Removed this element
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |  |  |  |  | Removed this element
encounter | S | 0..1 | Reference(US Core Encounter Profile) | Context of the document content |  |  |  |  | Removed this element
event |  | 0..* | CodeableConcept | Main clinical acts documented Binding: ?? (example): This list of codes represents the main clinical acts being documented. |  |  |  |  | Removed this element
period | S Σ | 0..1 | Period | Time of service that is being documented |  |  |  |  | Removed this element
facilityType |  | 0..1 | CodeableConcept | Kind of facility where patient was seen Binding: ?? (example): XDS Facility Type. |  |  |  |  | Removed this element
practiceSetting |  | 0..1 | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) Binding: ?? (example): Additional details about where the content was created (e.g. clinical specialty). |  |  |  |  | Removed this element
sourcePatientInfo |  | 0..1 | Reference(Patient) | Patient demographics from source |  |  |  |  | Removed this element
related |  | 0..* | Reference(Resource) | Related identifiers or resources |  |  |  |  | Removed this element
version |  |  |  |  | Σ | 0..1 | string | An explicitly assigned identifer of a variation of the content in the DocumentReference | Added this element
basedOn |  |  |  |  |  | 0..* | Reference(Appointment | AppointmentResponse | CarePlan | Claim | CommunicationRequest | Contract | CoverageEligibilityRequest | DeviceRequest | EnrollmentRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | SupplyRequest | VisionPrescription) | Procedure that caused this media to be created | Added this element
modality |  |  |  |  | Σ | 0..* | CodeableConcept | Imaging modality used Binding: ?? (extensible): Type of acquired data in the instance. | Added this element
event |  |  |  |  |  | 0..* | CodeableReference() | Main clinical acts documented Binding: ?? (example): This list of codes represents the main clinical acts being documented. | Added this element
bodySite |  |  |  |  | Σ | 0..* | CodeableReference(BodyStructure) | Body part included Binding: ?? (example): SNOMED CT Body site concepts | Added this element
facilityType |  |  |  |  | C | 0..1 | CodeableConcept | Kind of facility where patient was seen Binding: ?? (example): XDS Facility Type. | Added this element
practiceSetting |  |  |  |  | C | 0..1 | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) Binding: ?? (example): Additional details about where the content was created (e.g. clinical specialty). | Added this element
period |  |  |  |  | Σ | 0..1 | Period | Time of service that is being documented | Added this element
attester |  |  |  |  |  | 0..* | BackboneElement | Attests to accuracy of the document | Added this element
Documentation for this format